Question

History: Margaret Donovan, a 72-year-old white female, was brought to the emergency room by her son-in-law after falling in her bathtub. She was previously in good health, despite leading a relatively sedentary lifestyle and having a 30-pack-year history of cigarette smoking. The only medication she currently takes is Inderal (propranolol) for mild hypertension. She fell upon entering the bathtub when her right leg slipped out from under her; she landed on her right hip. There was no trauma to her head, nor does she complain of right or left wrist pain. However, she reports severe pain in the right hip and upper thigh and was unable to get up after her fall. An injection of oxymorphone hydrochloride (Numorphan) helped relieve her pain and she was taken to the radiology department for an X-ray of her right leg and hip.

Identify the parameters that may have contributed to Margaret’s fall

What would you ask her about the home environment and her level of activity?

What risk factors are present for blood clot formation?

Identify the signs and symptoms of a fracture. (3)

State the five classical complications of a fracture.

What is the most common immediate complication of a compound fracture of the leg? State the signs and symptoms.

What is a late complication of a compound fracture? State the signs and symptoms

What are the signs and symptoms of Osteomyelitis? (5)

Answer 1

<•>The parameters which have contributed to fall are

• Age
• Slip while ising the bathtub

<•>The following questions can be asked regarding her home environment and activities are

• Type of flooring (can give a brief knowledge on fall)
• Furniture and things arrangements in the home (a cluttered room can pose threat to fall)
• Does she perform activities in home like cooking, washing, cleaning, gardening,etc., to assess other co risk for fall

<•>The majot risk factor present for blood clot formation is high blood pressure or hypertension

Sedentary lifestyle

Age

<•>The signs and symptoms of fracture are

• Pain , tenderness
• Inability to mobilise
• Swelling at the site
• Redness due to injury
• Limping in case of fracture in legs
• Bruises abs scractvhes can be noted in the leg

<•>The classical complications of fracture are

• Neurovascular injury
• Infection
• Complex fracture
• Heamarthrocis
• Compartment syndrome

<•>In compound fracture the most common complication is infection.The signs and symptoms of it are

• Open wound
• Continuous or persistent pain

<•>The late complications of compound fracture are

• Malunion of the bones
• Loss of functions
• Osteomyelitis
• Formation of embolus

<•>The common side effects of osteomyelitis are

• Pain
• Swelling
• Increased body temperature
• Fatigue
• Body pain