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

Case - WT 74 yo male s/p MVA Multiple medical problems

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 , 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

JG ER CT scan ????

JG – night 1

JG CT scan after ex-fix

JG – 11 days

JG – 20 days

JG – 16 months

Needs R TTC fusion L ankle with some evidence AVN talus but minimal symptoms other than stiffness L knee: – No instability – 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

Case - PL 52 yo F MVA >250 lbs. HTN

PL – 52 yo F s/p MVA

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

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 – 3 years, No symptoms

Case - PH 35 yo Auto Mechanic involved in high speed MVA No PMH

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