术前病例讨论-跟骨骨折（Case discussion -- calcaneal fracture）.docVIP

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术前病例讨论-跟骨骨折（Case discussion -- calcaneal fracture）.doc

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术前病例讨论-跟骨骨折（Case discussion -- calcaneal fracture）

术前病例讨论-跟骨骨折（Case discussion -- calcaneal fracture） Essential information Zhao Moumou, female, 101 years old Main reason: fall caused by left knee pain, accompanied by limited activities 4 hours admission. Past history: at the age of 93 because of the eldest son died, the gradual emergence of confusion, the recent state of forgetfulness; family history, no history of drug allergy. Personal history: 60 years of smoking history, others without special. Admission status Conscious, nervous, passive position. Blood pressure: 200/90mmHg heart rate: 68 beats / min temperature: 36.8 degrees Specialist examination: left............., local swelling, subcutaneous ecchymosis and obvious blisters; tenderness, left lower limb longitudinal percussion pain significantly; left knee joint activity because of the pain of patients without detailed investigation, the left ankle joint activities is limited; the left foot pulse showed no abnormalities, no obvious abnormal limb feel. No obvious abnormalities were found in the remaining limbs. Left ankle direct film + calcaneal axial film 1. fractures of the calcaneus, 2. of the vertical fractures of the calcaneal tuberosity, 3. of the fractures from the hip, 4. of the compression fractures of the calcaneus, 5. of the comminuted fractures of the calcaneus Chest radiograph Bilateral lung markings increase weight and disorder, double lung field can be seen scattered calcification, aortic sclerosis and heart enlargement, the left ventricular enlargement is the main. (graph) electrocardiogram 1. sinus rhythm; 2. frequent atrial premature two; 3. left ventricular high voltage; 4. mild ST segment change. Blood routine and Biochemistry Blood gas and blood coagulation Initial diagnosis of admission 1. left tibial plateau fracture (Schatzker type II) 2. osteoporosis 3. hypertension (Rank 3 extremely dangerous) 4. arrhythmia - frequent atrial premature 5. Alzheimers disease Reflection The above inspection is perfect, if not perfect, what do you need