Patient experience from a doctor's perspective: A case report concerning treatment, fracture healing and rehabilitation of multiple complex injuries due to a high energy motor vehicle collision
A 35-year old healthy male trauma surgery chief resident, suffered a high-speed motor vehicle collision. The patient sustained the following injuries: a Gustilo-Anderson grade 2 open comminuted intra-articular fracture of the left distal femur (AO 33C3.3), a Hawkins 1A neck fracture of the right tal...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-12-01
|
| Series: | Trauma Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352644022000954 |
| _version_ | 1811293921072906240 |
|---|---|
| author | M.A. de Ruijter J.A. Lucke J.Z. Yuan R.J. Derksen |
| author_facet | M.A. de Ruijter J.A. Lucke J.Z. Yuan R.J. Derksen |
| author_sort | M.A. de Ruijter |
| collection | DOAJ |
| description | A 35-year old healthy male trauma surgery chief resident, suffered a high-speed motor vehicle collision. The patient sustained the following injuries: a Gustilo-Anderson grade 2 open comminuted intra-articular fracture of the left distal femur (AO 33C3.3), a Hawkins 1A neck fracture of the right talus (AO 81.2A), an undisplaced Lisfranc injury of the right foot comprising avulsion fractures at the base of the 1st, 2nd and 5th metatarsal as well as the cuboid bone suggesting ligament injury and 2nd to 5th carpometacarpal dislocations of the right (non-dominant) hand with comminuted fractures of the capitate, hamate, trapezoid and the base of the fifth metacarpal bone. A staged-treatment approach ensued. An external fixator (ex-fix) was placed over the left knee, followed by definitive fixation of the distal femoral fracture using a Qwix screw, Non-Contact Bridging (NCB) plate and Locking Compression Plate (LCP). An ex-fix was placed over the right wrist, followed by open reduction and k-wire fixation. The talar fracture of the right foot was treated with a single lag screw and the Lisfranc injury was treated non-operatively with four weeks of non-weight bearing cast immobilization.An intensive clinical rehabilitation program was started, including early use of Continuous Passive Motion (CPM), daily non-weightbearing swimming pool exercises, hand, physical and recreational therapy. One year after the injury the patient was rehabilitated and resumed his surgical residency. Two years after the injury, limited flexion and pain in the left leg remains, possibly related to partial union of the femoral fracture. Range of motion (ROM) of the right ankle and wrist remains limited, not causing significant functional impairment. Lessons learned from a patient experience combined with detailed descriptions of injuries, rehabilitation and long term outcomes can be used as a reference for treating patients with comparable injuries. |
| first_indexed | 2024-04-13T05:08:45Z |
| format | Article |
| id | doaj.art-ff5f25dea6084a2b8d77916e300dee21 |
| institution | Directory Open Access Journal |
| issn | 2352-6440 |
| language | English |
| last_indexed | 2024-04-13T05:08:45Z |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Trauma Case Reports |
| spelling | doaj.art-ff5f25dea6084a2b8d77916e300dee212022-12-22T03:01:05ZengElsevierTrauma Case Reports2352-64402022-12-0142100699Patient experience from a doctor's perspective: A case report concerning treatment, fracture healing and rehabilitation of multiple complex injuries due to a high energy motor vehicle collisionM.A. de Ruijter0J.A. Lucke1J.Z. Yuan2R.J. Derksen3Department of Traumasurgery, Zaandam Medical Centre, Zaandam, the Netherlands; Corresponding author at: Department of Traumasurgery, Zaandam Medical Centre, Koningin Julianaplein 58, 1502 DV Zaandam, the Netherlands.Department of Emergency Medicine, Spaarne Gasthuis, Haarlem, the NetherlandsDepartment of Traumasurgery, Zaandam Medical Centre, Zaandam, the NetherlandsDepartment of Traumasurgery, Zaandam Medical Centre, Zaandam, the NetherlandsA 35-year old healthy male trauma surgery chief resident, suffered a high-speed motor vehicle collision. The patient sustained the following injuries: a Gustilo-Anderson grade 2 open comminuted intra-articular fracture of the left distal femur (AO 33C3.3), a Hawkins 1A neck fracture of the right talus (AO 81.2A), an undisplaced Lisfranc injury of the right foot comprising avulsion fractures at the base of the 1st, 2nd and 5th metatarsal as well as the cuboid bone suggesting ligament injury and 2nd to 5th carpometacarpal dislocations of the right (non-dominant) hand with comminuted fractures of the capitate, hamate, trapezoid and the base of the fifth metacarpal bone. A staged-treatment approach ensued. An external fixator (ex-fix) was placed over the left knee, followed by definitive fixation of the distal femoral fracture using a Qwix screw, Non-Contact Bridging (NCB) plate and Locking Compression Plate (LCP). An ex-fix was placed over the right wrist, followed by open reduction and k-wire fixation. The talar fracture of the right foot was treated with a single lag screw and the Lisfranc injury was treated non-operatively with four weeks of non-weight bearing cast immobilization.An intensive clinical rehabilitation program was started, including early use of Continuous Passive Motion (CPM), daily non-weightbearing swimming pool exercises, hand, physical and recreational therapy. One year after the injury the patient was rehabilitated and resumed his surgical residency. Two years after the injury, limited flexion and pain in the left leg remains, possibly related to partial union of the femoral fracture. Range of motion (ROM) of the right ankle and wrist remains limited, not causing significant functional impairment. Lessons learned from a patient experience combined with detailed descriptions of injuries, rehabilitation and long term outcomes can be used as a reference for treating patients with comparable injuries.http://www.sciencedirect.com/science/article/pii/S2352644022000954TraumaFemoral fractureLisfranc injuryCarpal fractureRehabilitationPatient experience |
| spellingShingle | M.A. de Ruijter J.A. Lucke J.Z. Yuan R.J. Derksen Patient experience from a doctor's perspective: A case report concerning treatment, fracture healing and rehabilitation of multiple complex injuries due to a high energy motor vehicle collision Trauma Case Reports Trauma Femoral fracture Lisfranc injury Carpal fracture Rehabilitation Patient experience |
| title | Patient experience from a doctor's perspective: A case report concerning treatment, fracture healing and rehabilitation of multiple complex injuries due to a high energy motor vehicle collision |
| title_full | Patient experience from a doctor's perspective: A case report concerning treatment, fracture healing and rehabilitation of multiple complex injuries due to a high energy motor vehicle collision |
| title_fullStr | Patient experience from a doctor's perspective: A case report concerning treatment, fracture healing and rehabilitation of multiple complex injuries due to a high energy motor vehicle collision |
| title_full_unstemmed | Patient experience from a doctor's perspective: A case report concerning treatment, fracture healing and rehabilitation of multiple complex injuries due to a high energy motor vehicle collision |
| title_short | Patient experience from a doctor's perspective: A case report concerning treatment, fracture healing and rehabilitation of multiple complex injuries due to a high energy motor vehicle collision |
| title_sort | patient experience from a doctor s perspective a case report concerning treatment fracture healing and rehabilitation of multiple complex injuries due to a high energy motor vehicle collision |
| topic | Trauma Femoral fracture Lisfranc injury Carpal fracture Rehabilitation Patient experience |
| url | http://www.sciencedirect.com/science/article/pii/S2352644022000954 |
| work_keys_str_mv | AT maderuijter patientexperiencefromadoctorsperspectiveacasereportconcerningtreatmentfracturehealingandrehabilitationofmultiplecomplexinjuriesduetoahighenergymotorvehiclecollision AT jalucke patientexperiencefromadoctorsperspectiveacasereportconcerningtreatmentfracturehealingandrehabilitationofmultiplecomplexinjuriesduetoahighenergymotorvehiclecollision AT jzyuan patientexperiencefromadoctorsperspectiveacasereportconcerningtreatmentfracturehealingandrehabilitationofmultiplecomplexinjuriesduetoahighenergymotorvehiclecollision AT rjderksen patientexperiencefromadoctorsperspectiveacasereportconcerningtreatmentfracturehealingandrehabilitationofmultiplecomplexinjuriesduetoahighenergymotorvehiclecollision |