A case of poly trauma. Patient was travelling in a bus where he was hit by a lorry on 26.06.2015.Patient C/O severe pain & inability to use both lower limbs. C/O inability to stand & walk. Patient was initially treated at Govt.Hospital near Vellore where he was treated conservatively with splints, analgesics & suturing of right forearm. Patient had no H/O Loc/Ent bleed.
Patient had come at Sai ortho care hospitals for further management.
When patient was received at sai ortho care hospitals patient was observed to be in “HYPOVOLAEMIC SHOCK.” Patient was resuccitated with IV fluids & dressing of the compound wound over left femur was done. Patient was immediately shifted to ICU & was stabilized vitals was found stable. O2 support given due to de – saturation. Skin traction for both lower limbs was given. Wound swab from compound wound sent for Culture & Sensitivity.
X – rays taken for both lower limbs. Patient was diagnosed with
- Fracture shaft of femur right side.
- Comminuted compound fracture femur left side.
- Fracture both bones left leg.
- Comminuted fracture distal tibia & fibula right side.
After stabilizing the patient, fracture fixation was planned as a 3 stage procedure.
Stage 1: (30.06.2015)
Intramedullary nailing of right femur & external fixator application of left femur with wound debridement done on 30.06.2015.B.K.Slab given for both legs.
Stage 2 : (05.07.2015)
External fixator removal & intramedullary nailing of left femur. O.R.I.F. for right ankle done on 05.07.2015.
Stage 3: (11.07.2015)
Closed locking & intramedullary nailing of left tibia done on 11.07.2015
Patient is very comfortable.Vitals are stable.
Active mobilization of all joints started.
Quadriceps strengthening exercises started.