CASE STUDY

Case Study

Case Study

Introduction

Sometimes we riders tend to minimize the risks we hear about. Take, for example, what every student of the Motorcycle Safety Foundation has heard about 'target fixation'. This, of course, is the phenomena wherein our motorcycles tend to go in the direction we are looking and is usually described with an example familiar to all -- that if Intensive Care nurse see a pothole in the street ahead of Intensive Care nurse and don't take your eyes off it Intensive Care nurse are likely to hit it.

Case Study: Intensive Care

A 39 year old man in intensive care after a motorcycle accident in which he skidded across the pavement on his right side . He has fractures of hie right femur, pelvis and several ribs on his right side. His leg was crushed beneath the motorcycle. and he is beginning to lose movement in his that leg.

The patients was treated within 36 h of their accident. There were no complications during surgery. The patient was mobilised in the first 24 h postoperatively, regardless of the fracture type, and weight bearing was permitted as tolerated. Union of the fracture was achieved in all patients. There was no mechanical failure of the implants despite the early patient mobilisation. Early operation and early mobilisation resulted in a good functional outcome in the patient.

An 11-mm distal diameter ACE trochanteric nail was used for the patient. Distal locking was performed with one locking bolt (always the proximal bolt for the ACE TN patient group). Thus, in no case was distal reaming necessary.

Postoperatively, the patient was given prophylactic antibiotics for 24 to 48 h and deep venous thrombosis prophylaxis (low molecular weight heparin) for 6 weeks. Patient was mobilised on the first postoperative day, regardless of the fracture pattern, and full weight bearing was permitted as tolerated.

Regular radiological and clinical examinations were performed in 1, 3 and 6 months postoperatively. The mobility status and the postoperative complications were recorded at the latest follow-up. For the patients with unstable fractures, the mobility status was calculated separately in additon.

For decades the implant of choice for the treatment of most intertrochanteric fractures was a sliding hip screw and side plate [15]. Reports of high failure rates especially in the treatment of unstable IT fractures and complications due to the greater surgical trauma [7] have led to the introduction of the Gamma nail (Howmedica). This implant was ...