HPI - Fall from standing height
How would you treat this patient?
HPI - Severe pain resistant to medical treatment for 6 months.
HPI - 60 years old man. Non smoker. Index injury May 2011. Hit by a collapsing tree
ORIF lat tibial plateau through lateral hockey stick approach. Synthetic bone graft/blocks used as significant lateral depression.
Removal of metalwork January 2013.
Ambulatory with a stick.
What is the best reconstruction options
HPI - History of basal neck fracture fixed with canulated screws
HPI - The patient, a retired professional tennis player, developed pain in his right arm approximately 12 weeks ago following a tennis match. Initially the pain was severe, but with a trial of physical therapy, and selective corticosteroid injections the pain resolved. However, now we continues to have significant weakness in the right arm that is severe enough that he can no longer play tennis anywhere near the level he use to. He reports some mild numbness and tingling in his right thumb. He denies any weakness or paresthesias in the left arm.
He reports ~ 30 years ago he had a diving accident where he hit his head and had immediate and severe neck pain. He denies having any neurologic symptoms at that time.
An EMG was done which showed a C5 and C6 radiculopathy.
How would you treat this patient with weakness (C5 and C6) and paresthesias (C6) but no significant pain.
HPI - RTA
What method would you use to remove this bone fragment?
HPI - 1 week old injury over finger Rt ring finger, treated by bone setter.
How would you treat this fracture-dislocation?
HPI - Fall from a standing height 1 day ago
How would you treat this fracture?
HPI - The patient sliped on floor.
HPI - History of trauma 14 days ago. Placed in cast at outside institution.
HPI - Progresive varus deformity noticed since 2 months
What is the most likely diagnosis?
HPI - motor vehicle accident.
How would you treat this fracture pattern?
HPI - pt is c/o pain swelling rt knee for 2 months
HPI - H/O Road traffic injury 2 days back, presented to us with closed left trimalleolar fracture with blister ( 1*1 cm) over medial malleoli and edema.
What fixation u suggest for posterior malleoli and medial malleoli,if patient has to be operated quickly (out of bed) due to cardiac reasons?
HPI - History of fall 3 week back
Closed reduction done
What should be further course of treatment
HPI - Bike accident, dominant arm: Very active person.
What type of postop treatment will you offerd to the patient.
HPI - h/o fall injury to the right arm
conservative or operative treatment
HPI - patient is a 12 years old boy came for right foot pain and tearing of his right shoe just beneath 1st metatarsal head
which treatment do you prefer
HPI - Fall from a standing height due to a seizure ( grand mal ) 4 days ago
Misdiagnosed hip dislocation, remaining dislocated for 3 days.
After 3 days, the hip was redused under anaesthesia and a capital head fracture occurred
What is the most appropriate treatment at this time?
HPI - 43 yr old male with shoulder pain. Hx of cuff repair 4 years ago.
HPI - 33 year old male, right handed, handworker.
Motorcycle accident one year ago with left shoulder trauma.
Initially diagnosed as AC joint sprain and treated conservatively.
Long rehab, didn't regain his work because of shoulder pain.
Seen for the first time in our office one year after his accident.
Assuming an EMG shows normal function of the deltoid, How would you treat this injury?
HPI - pt having h/o of neck femur 28 days back
operated with cemented modular bipolar
post op uneventfull
wt bear from 5 day and on 8th day c/o of pain hen ihe try to cross leg
visited on 12 day with dilocated bipolar
reduced under sedation and adductor tenotomy done wtih ankle skeletal traction given
on pt id non compliance
not maintain traction
pt came on 28th day with re dislocation this time painless
not reductible under sedation
no evidence of infection
What is the most likely cause of dislocation?
HPI - passenger TA
overriding injury, Lt foot lateral lay
What is your choice of treatment this patient?
HPI - Insidious onset gradually progressive spasticity of lower limbs since 6 years. associated weakness on lt lower limb. decreased sensation below xiphisternum.
How would you treat this patient as a FIRST LINE of treatment?
HPI - low back pain radiating to b/l lower limb (L>R)since 9 months
Associated numbness in b/l lower limb below L2.
Pain aggravated by bending forward, with activities.
normal bowel/bladder habits
HPI - Right-hand dominant 38 year old male.
Past Surgical History: Right open bony-Bankart repair ~ 20 years ago. 2 screws in-situ.
Complaining of recurrent instability x 15 years.
Daily pain and crepitus with ROM.
Equally bothered by pain vs instability.
How would you manage this 38 year old patient?
HPI - road traffic accident
What should be the next step in treatment for this patient with an articular step-off on the postoperative films?
HPI - 62yo female, no sports, retired. After fall in hiperflexión of hip with extended knee, presents pain, haematoma in posterior thigh
What treatment would you choose?
HPI - Fall from standing height 2 days ago
What is your preferred treatment?
HPI - twisting injury left foot while playing basketball
closed reduction or reduction with fixation
HPI - History OF RTA, sustained crush injury of the leg,and proximal femur fracture
What are the treatment options?
HPI - The patient fell down stairs 4 days ago and she injured her left leg.
How would you treat this injury?
HPI - A 2.5 years old male presents with this gait abnormality. He has flexion deformity walking gait in both knees which was first noticed when he started to walk about year ago.
HPI - Fall from a standing height 3 weeks ago , the patient denies to be operated
When is the best time to operate?
HPI - 60-year-old male crashed his Mountain Bike at ~20 mph descending a dirt fire road, impacting left elbow and shoulder.
HPI - fall at worksite into a narrow shaft.injury to both heels.
operative or conservative
HPI - History of trivial trauma to right thigh leading to pain and inability to bear weight.
Generalised muscular pain for last 5 years with weakness over both lower limbs for 3 years.
Cane assisted community ambulator for 3 years.
Non progressive swelling in the neck for last 7 years.
Further management of the Fracture Femur and Options for Prophylactic Fixation
HPI - High speed Motorbike injury. No loss of consciousness or head injury. Closed injury pelvis with 4 rib fractures on the right side and transverse process fracture of L4-5 vertebrae bilaterally. No chest or abdominal injury.No urogenital injury.
How do you treat? Please state your views and reasoning behind it.
HPI - Patient had fracture of clavicle 3 months back, now presenting with deformity and pain around shoulder.
How would you treat?
HPI - 22 yrs male with 1 months old fracture, right hand dominance
HPI - fracture of left hip a year ago,she didnot operate because of a cardiac ischamic episode
operation or not
HPI - Five years ago she began pain foot in sport activities.
Now icreasing pain in normal life
What is your treatment ?
HPI - Patient had surgery two weeks prior. Now there is discharge of pus from the wound.
HPI - Intertrochanteric fracture 10.2013 , intramedullary nailing with 1 distal screw.
No pain relieve until today 05.2013
What is your treatment?
HPI - Fall from standing height 13.05.2013
What is your surgical treatment?
HPI - 23yr old female presented to the ER 8 hrs following MVA sustaining injury to her pelvis and a perineal wound.
How would you manage further ?
HPI - History of injury to wrist in MVA and presented to us about 2 hrs after injury in ER with moderate to severe pain in the wrist region.
What is your diagnosis?
HPI - pain inabilty to stand after fall.
HPI - patient came with complains of wasting of hand musculature since a week as per his history.
HPI - Jumped out of second story house. Was found by police screaming and intoxicated.
What would you do for initial treatment