Chemical Explosion: A Case Study

Some additional Information that you maybe are unaware of after tambra hill reported the injury on 7/30/15 Dr. Sufia Palluck wrote A Prescription for 21 Hydrocodone - acetaminophen 10-325mg on 7/30/15 it was filled at Target Grand canyon shopping center on 7/31/15 Mrs. Tambra Hill had No Dental work done on 7/30/15 to require pain medication the medication was for the dislocated thumb that accord on the job 7/30/15 we hope this clears up injury location and occurrence enclosed below are the C4 document that we faxed to you and the photos of prescription bottle

I met Mr. Eigner at the office of Dr. Taha. Mr. Eigner reports he is not taking any pain medications at this time. He reports he has a jolting shooting pain to the right and left legs only occasionally. He denied any pain to his right forearm. X-rays taken showed good alignment and healing of the fracture. The incisions are all healed except for a couple small spots on the right ankle. There is some swelling to the right ankle which Dr. Taha said is to be expected. The range of motion to the left ankle and toes was good. The range of motion to the right stores was limited. Dr. Taha said there is scar tissue at times from this type of repair and he would like physical therapy to start working on that. He is still going to be non-weight bearing for another 6 to 8 weeks on the right leg. He is now allowed full weight bearing as tolerated to the left leg. Dr. Taha ordered a rolling scooter to aid with ambulation and stop using the wheelchair. I have contacted Reverence physical therapy and faxed the new orders so the service can begin. I will process the rolled scooter with directions from the adjuster. The attendant care and replacement services will continue through to the next appointment.

Specificity: The ICD-10 codes allow you to identify etiology, anatomic site, and severity, as well as specify the encounter: initial, subsequent, or sequel of an encounter. In ICD-10 a "fracture of the forearm" can become a "torus fracture of lower end of right radius, initial encounter for closed fracture. That's just

The symptoms are described as dull and sharp. Weight bearing and putting pressure aggravate the pain. Current pain level is 6/10. The exam of the left lower extremity showed that the pin sites were completely healed. Skin was intact. Pulses were palpable. He was able to range his ankle comfortably. He virtually had no motion of the subtalar joint. His pain was over the lateral part if the subtalar joint. The foot was warm. Pulses were palpable. He was intact neurovasculay. There was no calf pain. Reported CT scan demonstrated that the calcaceus fracture was healed. The patient has post-traumatic subtalar joint arthritis and calcaneal cubital joint arthritis. Plan: steroid injection, shoe wear and activity modification. If conservative treatment fails, he will benefit from a subtalar joint

An intermetacarpal sprain happens when connective tissues (intermetacarpal ligaments) between bones in the hand (metacarpals) become torn (ruptured) or overstretched. This usually happens because of an injury to the hand.

PROCEDURE: The patient was placed in the supine position on the operating room table, where her right hand and forearm were prepped with Betadine and draped in a sterile fashion. We infiltrated the thenar crease area with 1% Xylocaine, and once adequate anesthesia had been achieved, we exsanguinated the hand and forearm with an Esmarch bandage. We then created a longitudinal incision just at the ulnar aspect of the thenar crease and carried the dissection down through the subcutaneous tissue. We identified the transverse carpal

The right humerus shows evidence of a transverse fracture, unknown if ante or post mortem, with teeth marks from scavengers. The right radius and ulna appear normal, with minimal damage from weathering and scavengers.

Some of the injuries that can occur in the hand are Cubital Tunnel Syndrome and Carpal Tunnel Syndrome along with many more. Cubital Tunnel Syndrome causes pain or numbness in the ring and little fingers, but could also go to the arm (Types of RSI, 2010). Occurs when the ulnar nerve is pinched along the elbow’s edge (“funny bone”), and has tingling or painful feeling (Types of RSI, 2010). Cubital Tunnel Syndrome can be treated by avoiding putting pressure on the “funny bone” (Types of RSI, 2010). Cubital could lead to surgery if the nerve needs to be relieved. Carpal Tunnel Syndrome is similar to Cubital but occurs in the three first fingers. A major nerve is compressed which passes over the carpal bones through the front of the wrist (ASSH, 2015). When the nerve is compressed it causes painful, tingling and numbness in the first three fingers (ASSH, 2015). Carpal Tunnel Syndrome can be treated without surgery by changing the patterns of hand use and/or wearing wrist splints at night (ASSH, 2015). If severe then surgery can take place to make the nerve have more

HISTORY OF PRESENT ILLNESS: Ruby Pearce follows up today for reevaluation of her left proximal humerus fracture sustained secondary to a fall on July 9, 2015. She was seen in the office on July 15, 2015 and a course of nonoperative treatment for proximal humerus fracture was begun. She was given a prescription for physical therapy and instructed on home exercise program including pendulum motions and wall walking. She has not attended physical therapy, but has been diligent with her home exercise program. Her pain is intermittent and sometimes sharp, but is easily controlled with medications. She states she has a 5-6/10 at times. She takes Tylenol to control these symptoms. She notes no neurovascular

There are many specific types of fracture that occur in the thumb and first metacarpal, fractures of the proximal phalange and distal phalange are simpler to manage than the more complex Bennett and Rolando fractures which involve the joint between metacarpal and carpal bones (Day & Stern, 2010). If a fracture occurs in the first metacarpal, or proximal or distal phalange the patient will experience pain to the thumb, the area may appear bruised and will swell; patient also in most cases experience a loss in function and are unable to complete tasks such as pinching motions (The Royal Berkshire NHS Trust, 2013). Anne is not experiencing any loss of function in her arm and there is no swelling of the thumb; consequently, it is unlikely that Anne has fractured her first metacarpal, distal or radial

Locoregional anesthesia was routinely used in non-fasting, cooperative or unfit patients while general anesthesia was the routine in patients who are uncooperative, irritable or medically fit. Pneumatic tourniquet was routinely applied at the midarm with pressure that was 70-100 mmHg above systolic blood pressure. Place the patient supine on the operating table with the arm on an arm board in 90° abduction, full extension of the elbow and forearm pronation. A straight longitudinal dorsal incision was used for exposure of metacarpals; however, proximal phalanges were exposed through a mid-lateral approach. The extensor apparatus was drawn aside and the periosteum was longitudinally incised and elevated to expose the fracture site preventing

2) Intermediate anterior column fracture, where the fracture line exits from the anterior border of the

The primary cause of a fracture is trauma from car accidents, sports injuries and falls. The trauma may be a direct blow to the bone or an indirect force from muscle contractions or pulling on the bone. Other factors that may contribute to fractures include: vigorous exercise, malnutrition, genetic factors, and osteoporosis. The most common cause of a distal radius fracture is falling onto an outstretched arm (Ignatavicius & Workman, 2013). “Wrist fractures of the distal radius are common and may present special problems for the surgeon and therapist. There are several categories of distal radius fractures, but the Colles fracture of the distal radius is the most common injury to the wrist and may result in limitations in wrist flexion and extension, as well as forearm pronation and supination, resulting from the involvement of the distal radioulnar joint” (Early, p.613).

Type 0 RCH, which represents the radial-deviated hand with a normal-length radius, is caused by a deficiency in the radial wrist extensors and flexors {Mo, 2004 #236;James, 2004 #237}. Not all cases with type 0, type I, or type II RCH need surgical correction. Splinting and stretching alone are frequently used to treat these patients. When patients have a significant radial deviation of the hand at rest, however, surgery can be indicated {Wall, 2013 #44;Mo, 2004 #236}. Mo and Manske have described correction of RCH type 0 with tendon transfers and soft tissue rebalancing {Mo, 2004 #236}. The procedure is partially based on the radialization procedure of BuckGramcko {Buck-Gramcko, 1985 #392}. The ECU is divided leaving a distal stump attached to the fifth metacarpal. It is then transferred into the dorsal wrist capsule at the level of the third metacarpal to help improve any existing extension deficit. The extensor carpi radialis tendons (if present) are transferred to the distal stump of the extensor carpi ulnaris (ECU) to transfer the force of the abnormal forearm muscles to the ulnar side of the wrist, resulting less radial deviation. While long-term results were lacking in Mo’s study, early postoperative

PROCEDURE: The patient was placed in the supine position on the operating room table, where her right hand and forearm were prepped with Betadine and draped in a sterile fashion. We infiltrated the thenar crease area with 1% Xylocaine, and once adequate anesthesia had been achieved, we exsanguinated the hand and forearm with an Esmarch bandage. We then created a longitudinal incision just at the ulnar aspect of the thenar crease and carried the dissection down through the subcutaneous tissue. We identified the transverse carpal ligament and incised this