Case Study - Fractured Leg
Nadine Michaelson, a 14 years old girl when skiing, fell and broke her left leg. When she fell, her left leg was caught under the body of another skier who ran into her. Doctor performed X-ray (a technique that gives a shadow image of an object) on Nadine’s leg. The X-ray showed that Nadine had an open, tibial-fibular fracture just below the knee. Fig 1. Open tibial-fibular fracture9
Tibia and fibula are the two bones located right below the knee area; out of the two the tibia is the weight bearing bone, which means that tibial fractures are usually linked with fibular fracture, due to the impact tibia would have on fibula 1. In open fracture, the broken bone tends to penetrate the skin, while in a closed fracture it doesn’t 2. Due to breaking of the skin, dermis and infection can travel to the fracture site and infect the bone, which is why immediate response is necessary to clean up the fracture area 2. Further, x-ray also showed a torn meniscal cartilage in the knee above the fracture. When the bones collide against each other, they tend to create shocks; meniscal cartilage is a type of shock absorber in the knee joint which helps in stabilizing the knee joint 4. It also functions in distributing the body weight over the knee joint 5.
Fig 2: Diagram of the Knee10
Nadine had to stay in the hospital for 14 more days due to the infection in the area of skin breakage. Nadine`s broken leg was casted after the infection has lessened. The cast is helpful for keeping broken bones in place, provide very little or no movement, bending, or stretching of the knee 6. They are usually made of fiberglass or plaster. Nadine had the cast on for 3 full months, after which the upper portion of the cast was removed and she was allowed to start bearing weight on her fractured leg. The bones eventually healed, but Nadine continued to have left swelling knee, and the pain got worse by walking. The swelling of the knee is usually due to an excess amount
Tibia and fibula are the two bones located right below the knee area; out of the two the tibia is the weight bearing bone, which means that tibial fractures are usually linked with fibular fracture, due to the impact tibia would have on fibula 1. In open fracture, the broken bone tends to penetrate the skin, while in a closed fracture it doesn’t 2. Due to breaking of the skin, dermis and infection can travel to the fracture site and infect the bone, which is why immediate response is necessary to clean up the fracture area 2. Further, x-ray also showed a torn meniscal cartilage in the knee above the fracture. When the bones collide against each other, they tend to create shocks; meniscal cartilage is a type of shock absorber in the knee joint which helps in stabilizing the knee joint 4. It also functions in distributing the body weight over the knee joint 5.
Fig 2: Diagram of the Knee10
Nadine had to stay in the hospital for 14 more days due to the infection in the area of skin breakage. Nadine`s broken leg was casted after the infection has lessened. The cast is helpful for keeping broken bones in place, provide very little or no movement, bending, or stretching of the knee 6. They are usually made of fiberglass or plaster. Nadine had the cast on for 3 full months, after which the upper portion of the cast was removed and she was allowed to start bearing weight on her fractured leg. The bones eventually healed, but Nadine continued to have left swelling knee, and the pain got worse by walking. The swelling of the knee is usually due to an excess amount
References: 1. Norvell, J., Steele, M., & Cooper, T. (2011). Tibia and fibula fracture. Retrieved from http://emedicine.medscape.com/article/826304-overview 2. Cluett, J. (2012, May 27). Open fracture. Retrieved from http://orthopedics.about.com/cs/brokenbones/g/openfracture.htm 3. Cluett, J. (2003, August 01). Closed fracture. Retrieved from http://orthopedics.about.com/cs/brokenbones/g/closedfracture.htm 4. Knee injury - meniscal cartilage tear. (n.d.). Retrieved from http://www.patient.co.uk/health/Knee-Injury-Meniscus-Cartilage-Tear.htm 5. Cluett, J. (2012, May 07). Meniscus tear. Retrieved from http://orthopedics.about.com/cs/meniscusinjuries1/a/meniscus.htm 6. Cast types and maintenance instructions. (n.d.). Retrieved from http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/orthopaedics/casts.html 7. Cluett, J. (2009, January 02). What is 'water on the knee? '. Retrieved from http://orthopedics.about.com/od/kneesymptoms/f/waterontheknee.htm 8. Cluett, J. (2011, May 02). What causes knee swelling?. Retrieved from http://orthopedics.about.com/od/hipknee/f/kneeswelling.htm 9. http://orthopedics.about.com/od/brokenbones/l/blxray_lattibia.htm - x -ray figure 10. http://victoriawellness.com/wp-content/uploads/knee-meniscus.jpg