Case Discussions Lower Extremity. Case - NL 57 yo female s/p MVA No significant medical history LOS...
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Transcript of Case Discussions Lower Extremity. Case - NL 57 yo female s/p MVA No significant medical history LOS...
Case Discussions
Lower Extremity
Case - NL
• 57 yo female s/p MVA
• No significant medical history
• LOS at scene, Pulmonary Contusion with CT
• Pain and deformity and swelling knee
NL
NL
NL
NL
NL
Case - WT
• 74 yo male s/p MVA
• Multiple medical problems
WT – December 2010
WT – December 2010
WT – December 2010
WT – Night 1
WT – 2.5 weeks s/p injury
WT – 11 months s/p injury, pain over plate ROH and NEGATIVE BX
WT – No change in Xrays 6 more months non-op Tx, “Too much Pain”, ROM 30-85
WT – 1 yr s/p TKR: ROM 10-110, No pain
Case
• Pt is a 29 year old male who fell from the bed of a pick up truck four days ago;
• Complains of right knee pain only
Case
Courtesy from OTA – RCFC archives
Case
Courtesy from OTA – RCFC archives
Case #3
Courtesy from OTA – RCFC archives
Case
Courtesy from OTA – RCFC archives
6 months
Courtesy from OTA – RCFC archives
Case - JG
• 22 yo female• MVA – ejected• + LOC• B/L open talus and right calcaneus• Swollen and tense L calf with PAIN!
JG
JGER CT scan
????
JG – night 1
JG – night 1
JGCT scan after ex-fix
JG – 11 days
JG – 20 days
JG – 16 months
JG – 16 months
• Needs R TTC fusion • L ankle with some evidence AVN talus but
minimal symptoms other than stiffness• L knee:
– No instability– 5-110 ROM– Intermittent pain at times at lateral joint line but
satisfied currently
Case - MB
• 38 yo M postal worker on his way home from work, shot through car window by 14 yo M who was “pledging” a local gang
MB
MB
MB
Case - PL
• 52 yo F MVA
• >250 lbs.
• HTN
PL – 52 yo F s/p MVA
PL
PL
PL – Refuses Arthroplasty
PL
• Infero-medial quadrant irreconstructible• Intra-op shaping of femoral head allograft for IM quad• Intra-op drilled native femoral head – No bleeding
PL
PL – 2 YEARS OUT
PL – 2 YEARS OUT
• Intra-op Femoral Head allograft completely incorporated• Advanced AVN superomedial quadrant
PL – 5 YEARS OUT – No symptoms
Case - FC
• 27 yo M s/p ped struck
FC
FC – after ER closed reduction
FC
FC
FC
FC – 3 years, No symptoms
Case - PH
• 35 yo Auto Mechanic involved in high speed MVA
• No PMH
PH
PH
PH
PH
PH
PH• 4 years out• Surprisingly mild sxs • OTC NSAIDs once / week• Full time mechanic• Plays basketball with children on weekends
PH• 4 years out• Surprisingly mild sxs • OTC NSAIDs once / week• Full time mechanic• Plays basketball with children on weekends
PH – 6 years out Lots of pain
PH – 1 yr after THA Happy, Full Duty Mechanic
DT
• 27 yo M s/p stolen car MVA
• Isolated Injury
DT
DT
DT
DT
DT