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PATIENT HISTORY:
A 22 year old professional footballer suffers closed transverse fracture of middle 1/3 of shaft of right tibia and fibula. ...
EARLY MEDICAL MANAGEMENT:
¡§Healing starts immediately after the fracture has occurred and is a continuous process¡¨ (Thomson et. ...
As mentioned by Adams and Hamblen (1999), ¡§The three fundamental principles of fracture treatment are: reduction, Immobilisation and preservation of function.¡¨ therefore, the next step is to REDUCE the fracture. ... But in this case closed manipulation is the best choice, as the patient suffers from a closed transverse fracture, with minimal displacement therefore the bone can be aligned readily without performing open reduction unless the need arises , probably due to ¡§Inadequate reduction by manipulation or when the plaster alone fails to maintain and acceptable position of the fragments ¡§ (Adams and Hamblen ,1999) . As for continuous traction it is mainly used if the patient is bed ridden, and both open reduction and traction mainly deals with spiral or oblique fractures which are less stable than transverse fractures, which is not again the case with this patient. ... Every method has its own pros and cons , like casts and plasters can effectively immobilize fractured bones but they could be quite heavy for certain people within a certain age or having limited strength and also have a tendency to make joints stiff if remained immobilized in the plaster for a long period , Whereas in case of External fixation is preferred when fractures cannot maintain their position or when there is extensive damage, it also corrects deformities related to angulations or shortening and can be used in open fractures where internal fixation ¡§cannot be used due to potential risk of infecting the soft tissues or aggravating infection . ... Therefore, out of this variety of methods to choose from, the appropriate choice for this case as even suggested by Smith (1987) is Plaster of Paris Cast which is done from slightly above the knee plaster, initially it should be a non-weight bearing cast for about 3-4 weeks, with the injured limb kept completely immobilized. ... By doing so the patient is encouraged to mobilize the knee and ankle which allows controlled micro movements at the fracture site and promotes callus formation ¡§( Dr. ...
This entire conservative treatment would last for 12-14 weeks until union of the fracture has taken place. ...
During or after this conservative treatment , there are possibilities of certain complications to arise like 1) Malunion ¡V ¡§ could occur when a fracture has united in an unacceptable position ¡§ ( Patrick H S Browne , 1983) 2) Delayed union or non union 3) Compartment syndrome : which could ¡§occurs as a result of increased pressure due to soft tissue swelling within a closed anatomical space such as the flexor osseofascial compartment of the lower leg (compartment bounded by bone and fascia).
Approximate Word count = 2059
Approximate Pages = 8.2
(250 words per page double spaced)
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