Patient Scenarios

Dr. Leonard diagnosis of Mr. Duszynski include Multi-trauma with rib fractures and bilateral closed ankle fractures. Mr. Duszynski lower extremities were splinted and he was admitted to trauma. Mr. Duszynski was placed on non-weight bearing status to his lower extremities and Dr. Edwards was also consulted.

I spoke with Mr. Sutter several times since 3/2/17. Mr. Sutter moved his medical appointment from 2/23/17 to 3/2/17. I was not unable to attend nor was I able to find a co-worker to attend. I spoke with Dr. Olenyn’s office staff many times for updated scripts and next appointment time. Mr. Sutter has lymph edema to the right and left legs. He was supposed to elevated and also wears compression stocking. His legs are so big the stockings cut in. Dr. Olenyn told Mr. Sutter he must get the swelling down because that will affect the healing of the fractures. He is at high risk for infections from open skin. Some of the bones are healing but not all. Mr. Sutter continues to use a bone stimulator daily. I have spoken with Mr. Sutter and

IMAGING: However, x-rays AP and lateral show a distal phalanx fracture at the base and the proximal tip but overall, relatively, minimally displaced

* Fractures of the Proximal Tibia-OrthoInfo - AAOS. (n.d.). Fractures of the Proximal Tibia-OrthoInfo - AAOS. Retrieved from http://orthoinfo.aaos.org/topic.cfm?topic=A00393

DOI: 12/14/2015. Patient is a 36- year-old male FIELD TECHNICIAN II who sustained a work related injury when he LOST FOOTING & FELL while WORKING ON SLIPPERY BUILDING LADDER.

The Department of Orthopedics and Traumatology of Cantonal Hospital St. Gallen is a licensed place for the instruction of specialists in the field of orthopedics and traumatology in all sections of the musculoskeletal framework, orthopaedie.kssg.ch(2017).

Per the IME report dated 07/22/14, patient is diagnosed with status post open reduction and internal fixation of the right ankle, right knee derangement and lumbago. From an orthopedic standpoint, there is a medical necessity for further orthopedic care for 2 months with one visit a month. A re-evaluation should take place in 8 weeks. Treatment is reasonable and necessary. No further PT is indicated as of this time. Patient stands at 5’9” and weighs 185 pounds.

It is to be noted that the patient was involved in a motor vehicle accident on 13/08/2012, at which time he sustained a fracture of the shaft of the left humerus. This was treated conservatively in a U-slab. Furthermore, Prof. Aden found that he also sustained a dislocation of the left shoulder as well as an open Lisfranc injury of the left foot. The shoulder dislocation was reduced and the open Lisfranc injury was cleaned, stitched, reduced and treated in a below-knee cast.

Background: The patient was a 19-year old male collegiate wide receiver without any previous history of ankle or foot injuries. During an attempt to jump for a pass during a football game, the patient came down on his left foot while in dorsiflexion, landing at the midfoot line. He stated that he felt an immediate “pop” in the middle of his foot and felt as though his toes touched his lower leg. He showed immediate signs of edema, and point tenderness along the first and second cuneiforms. The patient was unable to bear weight and after initial evaluation was placed in a walking boot, ambulated with crutches with no weight bearing. Radiographs taken after the injury showed signs of a Lisfranc dislocation, which was confirmed by the team orthopedic surgeon.

This 38-year-old gentleman is being seen today to look at his right foot and ankle. Patient has a history of bilateral foot problems and his care is documented in his chart. He is a somewhat vague historian but reports having his second toe of his left foot partially amputated a couple of years ago and reports he had a bone infection in the right foot with part of a bone being removed there. He thinks that was done last year and at that time, he had either a lengthening or a debridement of his Achilles tendon. Again, he is a vague historian but states he is a diabetic and has had problems with sensation and foot pain for years. He states the Achilles injury originally occurred when he fell at work in approximately 10/2016. Recently, a month ago, he felt a pop in the Achilles and states it has been more sore ever since. Apparently, he was put on crutches approximately two or three weeks ago but prior

DOI: 2/25/2016. The patient is a 38-year old male full-time lot attendant/porter who sustained a work related injury to his left knee due to twisting knee while walking down ramp after parking car. The patient is subsequently diagnosed with sprain of unspecified site of left knee, subsequent encounter. As per office notes dated 7/22/16, the patient returns for a follow up. The patient states that since the last visit, he stayed the same. He rated his pain as 3. Then patient is taking his medications as prescribed. He notes no adverse medication reaction or side effects. The patient is currently working at full duty. Physical examination revealed that the [patient appears to be in mild pain. Left knee examination revealed that superficial swelling

The patient’s heel spur was rather large, where it would cut into the plantar fascia ligament triggering her tangible pain.

Clinical examination was performed by an experienced orthopedic surgeon and included assessment of pain with motion, tenderness, and the ‘‘painful arc’’ sign. The usual complaint was pain during activity and constant chronic pain especially at night. The mean duration of symptoms was 9 months (ranged 3 –18 months).

7. A 48-year-old patient with a comminuted fracture of the left femur has Buck’s traction in

The patient is an 87-year-old female who presented to the ED because of pain after fall 3 days prior to admission. She had she fell at home had a mechanical fall she was preparing for a colonoscopy, felt weak, dehydrated and fell on her way to bed from the bathroom. She was seen in St. Mary's Passaic emergency room and was given some fluids and discharged. They did nothing to work from her hip pain. She normally ambulates around her home without a walker she uses it normally when she goes outside. Since the fall she has been using the walker and ambulating with great pain. In our ED she ultimately undergoes a CAT scan which shows inferior and superior pubic rami fracture on the right. Her medical history is significant for hypercholesterolemia