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