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    Clinical Case Presentation: Khalisshwary 131303130 Batch 33 Group G2

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    Sofea Izyan
    1. A 31-year-old man presented with restricted movement and swelling of his left shoulder and arm for 9 months following a car accident that resulted in a fracture of his left humerus. 2. He underwent surgery to fix the fracture but later developed an infection, requiring another surgery to remove the hardware and dead tissue. 3. On examination, he had loss of shoulder contour, muscle wasting, swelling at the fracture site, and restricted range of motion of the left shoulder and elbow. X-rays showed the fracture had not united. 4. He was scheduled for surgery involving plating and bone grafting to promote healing of the non-union fracture.

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    Clinical Case Presentation: Khalisshwary 131303130 Batch 33 Group G2

    Uploaded by

    Sofea Izyan
    56 views12 pages
    1. A 31-year-old man presented with restricted movement and swelling of his left shoulder and arm for 9 months following a car accident that resulted in a fracture of his left humerus. 2. He underwent surgery to fix the fracture but later developed an infection, requiring another surgery to remove the hardware and dead tissue. 3. On examination, he had loss of shoulder contour, muscle wasting, swelling at the fracture site, and restricted range of motion of the left shoulder and elbow. X-rays showed the fracture had not united. 4. He was scheduled for surgery involving plating and bone grafting to promote healing of the non-union fracture.

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    1. A 31-year-old man presented with restricted movement and swelling of his left shoulder and arm for 9 months following a car accident that resulted in a fracture of his left humerus. 2. He underwent surgery to fix the fracture but later developed an infection, requiring another surgery to remove the hardware and dead tissue. 3. On examination, he had loss of shoulder contour, muscle wasting, swelling at the fracture site, and restricted range of motion of the left shoulder and elbow. X-rays showed the fracture had not united. 4. He was scheduled for surgery involving plating and bone grafting to promote healing of the non-union fracture.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    56 views12 pages

    Clinical Case Presentation: Khalisshwary 131303130 Batch 33 Group G2

    Uploaded by

    Sofea Izyan
    1. A 31-year-old man presented with restricted movement and swelling of his left shoulder and arm for 9 months following a car accident that resulted in a fracture of his left humerus. 2. He underwent surgery to fix the fracture but later developed an infection, requiring another surgery to remove the hardware and dead tissue. 3. On examination, he had loss of shoulder contour, muscle wasting, swelling at the fracture site, and restricted range of motion of the left shoulder and elbow. X-rays showed the fracture had not united. 4. He was scheduled for surgery involving plating and bone grafting to promote healing of the non-union fracture.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 12

    CLINICAL CASE

    PRESENTATION
    KHALISSHWARY
    131303130
    BATCH 33
    GROUP G2
    Patient profile
    Name : Muaz bin Hj. Mohd Noor
    Sex : Male
    Age : 31 years old
    Occupation : Lecturer
    Race : Malay
    Relationship status : Married
    Date of Admission : 2/4/2017
    Date of Examination : 4/4/2017
    Chief complaints
    1. Restricted movement of the left shoulder and left elbow joint for 9
    months
    2. Swelling of the middle left arm for 5 months
    History of Presenting Illness
    • Patient was apparently well till 9 months ago
    • Patient encountered a motor vehicle accident in July 2017, 9 months
    ago. His car skidded and collided with a tree. He sustained closed,
    displaced fracture of left mid-shaft of humerus. Open reduction and
    internal fixation was done.
    • 4 months later, in November 2017, patient developed acute infection
    at the fracture site involving the internal fixators. He underwent
    another surgery to remove the internal fixators and dead tissue.
    History of Presenting Illness
    • Post surgery patient continued experiencing restricted movement of
    the left shoulder and elbow joint. He claims he felt an additional joint
    at the fracture site.
    • He also noticed painless swelling over the fracture site which is hard
    in nature. Swelling did not increase or decrease in size and there are
    no signs of inflammation noticed.
    • Activities of daily living are affected as he has not regained full use of
    his left hand post trauma.
    • The wrist joint and fingers are unaffected
    History of Presenting Illness
    • He sought medical attention as the restriction of movement and swelling
    continues to persist with no improvement
    • X-ray was done and the fracture site was found to be not united.
    • He is scheduled for surgery on 4th April 2018  Dynamic compression
    plating and autologous iliac bone grafting

    • Past medical history


     Patient was diagnosed with alpha-thalassemia when he was being treated after
    the car accident
    • No other significant history
    Provisional Diagnosis
    • Non union of closed fracture of the left mid-shaft of humerus
    secondary to post-traumatic osteomyelitis with no neurovascular
    complications
    Local Examination
    • Inspection
    Loss of shoulder contour
    Presence of muscle wasting in the arm and forearm
    Swelling is localized at the middle third area of the arm
    Presence of petechiae
    Scar measuring approximately 15cm
    No apparent limb length discrepancy
    Local examination
    • Palpation
    Swelling is tender on deep palpation, hard in nature
    Bony irregularities and thickening of bone upon palpation of
    humerus
    Gap felt at the fracture site.
    Muscle wasting is confirmed
     Left arm 27.5 cm
     Right arm  29 cm
    Local examination
    • Range of movements
    Shoulder joint  Restriction of left 20 degree terminal extension, terminal 30
    degree flexion, 30 degree abduction due to the deformity
    Elbow joint  restriction of terminal 20 degree flexion

    • Measurements
    True limb length
     Right : 59cm
     Left : 61 cm
    Segmental length
     Right humerus : 31cm
     Left humerus : 33 cm
    Radiological findings
    Management Plan
    • Patient is planned for dynamic compression plate surgery and
    autologous iliac bone grafting

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