Trauma Week 2022

As the football players had a play, a student Connor, had an interaction with another player. Dave, our physical trainer, immediately acted by walking swiftly to the hurt player onto the football field where he was laid out on his back with his right leg bent and grasping onto his left leg. After Dave examined the patient, he needed help from Dr. Slaughterback and Dr. Rippey who are also physical trainers. As they examined Connor they found out that he had an Open Tib-Fib Fracture. Dave immediately gave a signal to the EMT’s and they started making their way to the hurt player. The EMT’s also gave the player another examination to make sure there weren't any head injuries or other minor injuries that needed to be addressed. Once he was put on a stretcher, he was taken away in an ambulance to head straight to the Emergency Room. The EMT’s made sure he was kept stable and kept an eye on him for any disturbances that would be caused from the injury. As he arrived at the Emergency Room they started to push medicine. It is to help with pain, bacteria, and swollen body parts. The second thing to make sure of is that the wound is cleaned out completely and covered properly. After making sure the wound and the patient are taken care of they made sure of any more serious injuries that could have taken place due to the circumstances. One thing to always remember is never focus on one injury because there could be injuries that can’t be seen by the eye.

After the main injuries were checked out an orthopedic surgeon, Dr. Slaughterback came to check the patient and started to prepare for the surgery. In preparation for this surgery Dr. Slaughterback cleaned the wound thoroughly with a squirt bottle filled with water and soap. It typically takes a half hour to clean the wound. Then one to two hours of surgery. Depending on how bad the fracture is determines how the surgeon will take his next step into deciding what exactly to do. The surgeon has many options he can choose from including: Pins and Rods which will hold the leg and bone in place to keep it stable, Plates which hold the leg in place but it can cause bacteria which will cause life long complications, and a Tibia Nail which is surgically put behind the knee and goes through the bone marrow to repair the open fracture. According to Dr. Slaughterback plates genuinely don't fix open fracture wounds because of the bacteria and placing the weight on the plate will not heal this fracture. It will put unnecessary pressure that doesn’t need to be put on the injury. Surgery doesn’t completely fix the injury, it is a long process and in some cases could never be fully healed.

Many examinations later, Dr. Peter Rippey, a Family and Sports Medicine Associate found out that the patient, Connor, was having signs and symptoms of a concussion. This concussion was caused from the football play which had a disturbance on his brain function. The symptoms that led to the diagnosis of a concussion were light sensitivity, sound sensitivity, feeling “foggy”, nausea, trouble concentrating, not eating like normal, and accident prone. Concussions are 30% of sport related incidents. Concussions have become a more regular thing, but doctors still have no certain way of diagnosing a concussion. They are mostly diagnosed clinically. A CT Scan won’t even show a concussion, it just rules out more severe injuries such as brain bleeds or a swollen brain from the inside. Doctors can look for ocular symptoms which are the way of eye movements. A doctor mostly has to use the patient's word and certain movements of the body to determine a concussion. The question as a doctor is “ Are these symptoms caused from somewhere else?” You can never be too careful when it comes to your patients' health and care. After hearing about Dr. Rippey’s overview on concussions brought me to the realization that they can be deadly and can cause life long complications if not taken care of properly.

After Connor had been examined by many doctors and received surgery, he still had to go through Physical Therapy. He had his first appointment for PT four days after his surgery. During his first appointment the Physical Therapist wants to check out his range of motion, his ability to walk, making sure the wound is cleaned and healing well, and to check his ACL to make sure that it isn’t affected in any way. After examining the patient’s ankles the strength in his left ankle is ⅖ when it is supposed to be 5/5 which is what his right ankle is. In PT they also check the EDEMA/GIRTH measurements, which on his right side the measurements were normal for this patient but his left side, the same leg as an injury, the measurements were lower which was a result of irregularity for this patient. So they examined the patient's ACL and found out it was abnormal, which resulted in a tear of his ACL. After figuring this out the Trainer checked the patient’s pulse in his foot to make sure blood was still circulating. The treatment they used was called “NMES” which is the shocking of the muscles which is trying to get the patient to move on his own without minimal assist and “DVT” which is used to prevent a blood clot. The whole reason that a patient undergoes Physical Therapy after a severe trauma is to get their muscles, joints and bones working with the brain to start working normally again.

Our last speaker we heard from was Dr. Slaughterback. He had already talked to us about the surgical side but now that PT found an ACL tear it was his turn to step back in. An ACL tear is an injury that is a tear or sprain of the Anterior Cruciate Ligament. As an athlete there is also a risk of tearing your ACL but it can also be caused from slipping on ice, falling, and being out of shape. In this case, Connor tore his ACL from the football play where he also had an Open Tib-Fib Fracture and a Concussion. There are two treatments that Dr. Slaughterback could choose from which are an Arthroscopy and ACL Reconstruction. Arthroscopy is when a surgeon makes a small incision in the patient’s skin, then inserts a pencil-sized instrument that contains a small lens and lighting system to magnify the structures in the joint. This gives the surgeon the ability to see the interior of the joint through a very small incision, instead of the larger incision needed for open surgery. ACL Reconstruction is a surgical tissue graft replacement of the Anterior Cruciate Ligament to restore its function after the injury was caused. The torn ligament can either be removed from the knee or saved and fixed. ACL injuries are serious but they can be fixed.

After hearing from all the great doctors, I have come to the realization of what each one has to go through if the patient is dealing with an Open Tib-Fib Fracture. Each one has to examine the patient many times to figure out what has happened and if there are any undetected injuries. This injury can be very serious and cause many more injuries just like in this case. One doctor can determine the path they have to go through with the patient so all doctors need to be aware of every situation and be educated for everything that can be possible. This was an amazing opportunity to be apart of and brought me to a better understanding of some of the jobs in the medical field.