Virtual Trauma Meetings at the Grand Academy of Lagado - 35 Year Old Male, Femoral Fracture

Description

In this virtual trauma meeting led by Sally Rankin, the focus is on orthopedic case discussions aimed at enhancing knowledge for undergraduates, utilizing the expertise of orthopedic trainees and consultants. Jonathan French presents a traumatic case of a 35-year-old male who was struck by a four-wheel drive vehicle while at a petrol station, resulting in an inability to bear weight due to a leg injury. Following the incident, he was treated with a Thomas splint to immobilize the leg and was placed under spinal immobilization following ATLS protocols.



The assessment follows the A to E format typical in trauma evaluations, ensuring thorough examination of the airway, breathing, circulation, disability, and any other essential considerations. Jonathan and Henry Burnand lead a detailed discussion on the management of suspected spinal injuries, potential complications of cervical spine trauma, and appropriate imaging protocols, emphasizing the importance of CT scans in trauma cases. They proceed to evaluate the leg injury, examining the x-rays and identifying a multi-fragmentary fracture of the femoral shaft.



A thorough review of treatment options reveals that while a Thomas splint can provide initial stabilization, transitioning to skin traction is advisable to avoid complications from prolonged splint usage. The decision between surgical interventions—intramedullary nailing or plate fixation—is explored further, considering the advantages of nails over plates, particularly their ability to handle weight-bearing stresses more effectively.



Post-operative care and potential complications are also addressed, focusing on neurovascular integrity, pain management, and considerations for safe early mobilization. The discourse stresses the significance of patient expectations regarding recovery, planning for a realistic timeline for return to normal activities and sports. The session concludes with invitations for feedback and queries on future programs, ensuring continuous learning and improvement in the field of trauma care.

DOI: 10.1302/3114-230165

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