HPI - 20-year-old male with left thigh deformity , pelvic pain, splenic rupture after a car accident, hemodynamically instabile at presentation
How would you treat this fracture?
HPI - a 75 YO, Female patient, presented to our ER Dept. complaining of painful arm and inability to move her shoulder.
How would you classify this fracture?
HPI - Non dominant hand . No medical problem . Patient is a taxi driver
How would you treat this injury?
HPI - 90 y/o unassisted community ambulating female involved in a MVC who presents with isolated, closed tibia fracture.
HPI - 84 yr old borderline Diabetic, had a standing fall and was unable to move after that. Is otherwise well preserved.
How will you treat this elderly lady?
HPI - Dementia-specific nursing home patient
Fall whilst ambulating to bathroom with four wheeled frame
How would you manage the proximal femur fracture?
HPI - 40-year-old healthy male with isolated lower extremity pain after a motorcycle collision.
HPI - The patient suffered this injury after road traffic accident , the pt is otherwise free
what is the best treatment option
HPI - 74 yr old Asthmatic and Diabetic had a fall in the bathroom yesterday and is unable to walk despite using a walker
How would you treat this patient?
HPI - acute injury with cricet ball while playing cricket
HPI - While running the patient twisted his ankle and had an immediate onset of pain and swelling.
How would you treat this fracture based on the Preoperative Radiographs alone?
HPI - Right hand dominant farmer who fell from a stillage (ca. 1.5 m height) 12m ago. He sustained a right transolecranon fracture dislocation and a L1 burst fracture. Underwent ORIF olecranon and coronoid process with LCP olecranon plate and radial head replacement, L1 fracture being managed conservatively.
C/o painful limited ROM right elbow making it difficult to continue with his hard labour farm work. Pain whilst loading both in flexion and extension with pm over radial joint line. Recent Xrays suggstive for possttraumatic OA, possibly overstuffing of the radial head replacement.
How would you treat this patient's post traumatic OA
HPI - RTA 13 days back , open fracture tibia managed by debridement and external fixator ,a transverse fractures of the sacrum with anterior displacement. Referred from a local hospital for further management.
How would you classify this fracture according to the Denis classification?
HPI - MVA, sitting in rear seat without seatbelt. Crashed into a stationary lorry at 90km/hr.
HPI - 70 yr old very active, Hypertensive with Coronary Artery Disease, had a fall at home and could not bear weight on the right lower limb associated with severe pain. Had an Austin Moore prosthesis implanted for a fracture neck of Femur 8 years ago.
How would you classify this fracture as per the Vancouver classification?
HPI - pain on right foot. can not stand. sudden swelling after bike accident. no other issues. can bend leg, toes. He is on cast NWB.
What zone is this fracture in?
HPI - pain at rt leg since 4 months, gradual in on set progressive in nature,first swelling followed by pain,pain is increased on walking & relived by taking rest,no h\o trauma,fever ,wt loss,no similar complaints in the past.
what is your probable diagnosis ?
HPI - Patient presents with pain in left elbow after fall. Now has inability to move the elbow thru full range of motion.
HPI - Operated 2 times.
1st time non union with an intramedular nail no blocked proximal and distal
2nd time 1.5 years ago removal of the nail and plating with autograft, no compression of the non union site because of shortened lim
How would you treat this injury at this time.
HPI - Chronic left forefoot pain, incidentally discovered foreign body.
How would you classify this injury?
HPI - First pain complaints at the age of 10
What is the best surgical treatment at this stage
HPI - Unclear history of present illness. Fell down 6 weeks ago, pt presented in the hospital 3 weeks after the injury with severe knee effusion. Had a wash out of the knee with the possible diagnosis of knee septic arthritis. He has been d/c home with oral AB. No other details are known from this admission.
Admitted again in our Hospital with ascites and severe knee effusion. Arthroscopic wash out performed again, due to suspicion of a septic knee. Cultures and fluid analysis were negative for infection.
HPI - Over the past five years the patient noticed that her left knee was progressively swollen, became painful and experienced difficulties in ambulating independently. She started using a stick for support and was asking for regular analgesia.
HPI - Patient has a history of a fall after a twisting injury while walking.
Accorrding to the Vancouver Classification - What type of periprosthetic fracture is this
HPI - Patient had a gradually enlarging swelling over the poster medial aspect of the right distal tibia for more than one year.
Assuming the diagnosis is Giant Cell Tumor (osteoclastoma), what would be the next step in management?
HPI - Collided with a car while he was riding a motor bike 2 days ago.
HPI - He is a doctor presented with R / Hip pain for last 3 months. Temporarily responding to analgesics.
Based only on the radiographs, what is causing the patient's hip pain?
HPI - Patient had hip trauma 35 yrs back .no record available
Will flexion deformity 20 degree will correct with physio or release needed
HPI - - First intervention. Trauma July 2008: fracture of both bones (we do not have x-ray control of the fracture and intervention), compression plates with BioTek.
- Second intervention: 8 months after: radius nonunion, compression plate with autoplastic iliac crest graft. Healed
- Third intervention. Trauma Jan 2014: refracture of both bones, plates without grafting.
- Now comes by us with rx control: nonunion both bones.
The radius in all three cases as always been operated through Thompson approach
HPI - Patient sustained a fracture of the scaphoid 10 years ago, not diagnosed, 5 years ago had a styloidectomy
HPI - This lady has got bilateral feet ulcers and bad skin conditions of both leg and ankles for the last 9 months, skin graft was done and still on dressing and infection control.
The patient fell 3 months ago and hurt her Rt ankle. A splint was applied initially. The patient had a manipulation and cast for another one week.She continued to ambulate on the injured limb. External fixation was then applied and later removed.
How would you treat the initial injury?
HPI - case of MVA 2 months ago.sustained a degloving injury with rt tibia fibula fracture.treated in another hospital with external fixator and skin grafting.skin grafting coverage from knee to ankle
How would you treat this patient at this point?
HPI - 21 year male pt , no relevant medical hsitory.
Presented by this bad fracture dislocation thad has been reduced in ER but unstable . What is the best treatment option for this young patient?
what is the best treatment option?
HPI - 52 yo female anethesiologist complains of worsening R hip pain for several months. No specific injury although states that she "tweaked" it on several occasions. She is an avid, competitive tennis player
HPI - History of Motor Vehicle Collision, Pain, swelling and deformity right arm,
isolated fracture, no other fractures
HPI - History of fall 2 months ago and was treated by in another setup with a cast for 6 weeks. The patient has had 2 weeks of physical therapoy. Currently, he has moderate wrist pain with functional range of motion
HPI - Past untreated scaphoid nonunion. Wrist pain since two years ago. Now worse.
How would you treat this case?
HPI - Underwent ORIF 5 months prior to presentation. Denies any issues except pain.
How would you have treated the initial fracture?
HPI - h/o fall at basketball.injured non dominant limb
How would you treat the ulna
HPI - 39 y/o male s/p MVC with left hip pain. No prior hip pain or injury. This appears to be an isolated injury. Transferred from outside hospital after initial evaluation.
What would you classify this acetabular fracture as?
HPI - 32 yo male in head-on MVC. +ETOH. Polytrauma with all extremity injuries other than a head laceration. Also with L midshaft femur s/p IMN, R distal radius s/p ORIF, L pilon s/p exfix (pending ORIF).
Main concern: L grade 3A open segmental humerus shaft with 4 inches of distal bone loss including 75% of the articular surface. The medial half of the trochlea is all that remains. He also has a segmental olecranon fracture. There is no injury to the radius. He has undergone I&D, antibiotic bead placement, and ex-fix from the proximal humerus to the ulna shaft.
He is a firefighter. He needs to pass yearly physicals to keep his job.
What is the definitive solution for this patient, considering his current career as a firefighter?
HPI - Subtrochanteric hip fracture treated 4 months ago at a peripheral hospital. Transferred after loss of fixation and femoral head screw cut out. ESR, CRP normal. Vital signs stable. Wounds well healed.
What would be your approach in the management of this fracture?
HPI - MVA with closed fracture supracondylar femur and contralateral neck femur fracture
Best method of treatment
HPI - Patient sustained firearm injury from a very close range to his knee
How would you definitely treat this fracture?
HPI - 12 month history of pain worse in the last 2 month. Manual worker. occasional amateur soccer player. no history of trauma
What would your next step in management be?
HPI - History of road side accident 3 days back leading to injury left hip joint
HPI - H/O INJURY ON THE BEACH 3 WEEKS AGO.UNABLE TO BEAR FULL WEIGHT ON AFFECTED LEG AND LIMPING
HPI - He had closed fracture of R/ Femur following RTA in 2013. He was operated in a peripheral hospital and fixed with K nail and de rotation plate. He is now presented with pain and discharging sinus at he fracture site.
What will you do for this patient at this stage?
HPI - Had a fall from height 6hrs ago.
What would be the plan of management.
HPI - open tibia fx with bone loss 1 year ago treated with ex fix removed after 9 mo (patient didnt refer for f/u)
do you agree with treatmebt?
unfortunately appropriate sized nail was not available