CASE

PRESENTATION
BY WEDNESDAY ONCALLERS
CASE #1
A 5 year old boy ,H/x of fall from swing
O/E: closed injury at right leg on medial aspect
with mild swelling & tenderness .
Distal NV intact.
Unable to bear weight.
X –ray right leg (AP & lat. view):oblique fracture
of tibial shaft at middle 1/3,minimally displaced.
Back slab above knee was applied. His parents
were told to do repeat X-ray after PoP but they
didn’t comply. Discharged medications were given
with follow up in OPD on Monday.
CASE # 2
25 year old male ,brought on stretcher in ER .C/o
pain & restricted movement of left lower limb for 1
day ago . Hx of RTA(Bike vs. Bike).

O/E: Closed injury. Limb was externally rotated.

Mild swelling and tenderness at lat.aspect of left
proximal thigh. Painful and restricted movements.
Distal NV intact. Not able to bear weight.

X-ray Pelvis(AP view) and B/L hip joints revealed,

Intertrochanteric fracture of left femur.

IV NSAiDS and tetanus prophylaxis were given.

Skin Traction kit was applied and Referred to
JPMC/Civil Hosp due to unavailability of C-ARM.
 X-Ray Pelvis(AP view)
I Intertrochanteric # of left femur
X-Ray B/L Femur:
NBI
CASE # 3
40 year old male .C/o pain in left thumb for 1 day.Hx
of RTA(Bike slipped).Initially treated by bone setter.

O/E: closed injury, Mild swelling & tenderness at base

of thumb. Restricted Abduction of thumb. Capillary
refill < 2sec.

X-ray Right hand(AP & lat),:chip fracture of base of

1st metacarpal.

Splintage was applied with polysling and repeat x-ray

after PoP was advised. Discharged medications were
given with follow up in OPD on Monday.
CASE # 4
40 year old male ,c/o of pain & swelling of right foot
for 1hr.Hx of RTA(bike Vs footpath) .

O/E: Closed injury Swelling and tenderness at dorsal

aspect of right foot . Painful and restricted movements
.Not able to put weight . Distal NV intact.

X-ray right foot(AP & Oblique):fracture of base of 2nd

metatarsal . Back slab below knee was applied .
Discharged medications were given with follow up in
OPD on Monday.
.
 CASE # 5
An elderly lady of about 65 yrs,with NKCM ,c/o pain &
swelling of right wrist for 4 hrs. Hx of fall on outstretched
hand(FOSH)

O/E: Closed injury. Swelling and tenderness at right wrist.

Painful & restricted movements. Distal NV intact.

X-ray right wrist (AP & lat) :fracture of distal radius, dorsally
displaced(Colle’s fracture)

Back slab above elbow was applied(after relocation) and

polysling. Discharged medications were given with follow up
in OPD on Monday.
CASE # 6
5 year old male child.C/o of pain in left leg.Hx of RTA
O/E: swelling and bleeding from left leg with a punctured wound on medial aspect. Distal NV intact.
X-ray left leg(AP & lat): Midshaft fracture of left tibia and fibula with posterior angulation &
displacement.
Rx:Thorough wound wash & Dressing done.
Inj. ATS IM stat(vacc. Hx was incomplete)
Inj .Ceftriaxone 500mg IV stat
Manipulation & back slab above knee + polysling.
Patient Discharge on oral antibiotics and NSAIDs and told to review back on Monday.

 hxzz
Before Manipulation & PoP.
After Manipulation & PoP.