A «wrong» word can have unpleasant consequences. Many people have experienced this, including a young man in love. The story of love and suffering of this twenty-six year old was recently told by Peter Krapf, an orthopedic surgeon from Trier, Germany.
The patient and his story
The young man met «the love of his life» at a private party at the end of February last year.But unlike Shakespeare’s Juliet, this beloved young woman showed no interest. However, the lady’s contemptuous behavior had consequences: the rejected man drowned his pain in alcohol, as Krapf still describes. In a state of intoxication he called a party guest «complete idiot», to which the latter kicked him in the lower leg. The consequence of calcium was a spiral fracture in the distal third of the tibia and in the proximal third of the fibula; The young man was operated on the same day (osteosynthesis with intramedullary nail).
The course
In mid-March, the 26-year-old showed up for the first time in his office, Krapf said. Initially, healing proceeded without complications. Then, however, the pain increased, so much so that an MRI and a CT scan of the right ankle were performed.
The results: a large fracture with no signs of healing.Therefore the patient had to be operated on again (removal of the intramedullary nail and new intramedullary dynamic nailing).
The course after this second surgery was also initially uncomplicated. Later, however, increasing redness and pain occurred above the distal locking screw. In addition, inflammatory parameters are increased.
The «good end»
On July 11, the patient was readmitted to hospital. X-rays showed a bone callus of the fracture. But the inflammation became an abscess, which required an incision. MRSA (methicillin-resistant Staphylococcus aureus) was detected on culture examination. Intravenous antibiotic therapy was successful. Four months later, radiological checks showed «clear signs of fracture healing without persistent evidence of inflammatory changes.»
PS: According to Krapf, the young man married the woman of his heart, despite the unhappy start.
Comment
A kick to the leg is probably a very rare cause of fracture.Up to age 40, lower leg fractures «are mostly caused by high-energy traffic accidents in the form of direct impact,» trauma surgeons at the University of Munich explain. In people over the age of 65, the most common traumatic mechanism is a fall. Fractures that are pathological or associated with osteoporosis are rare.
The youngest people are those mainly affected, with an incidence of 18/100,000 people per year. Fractures to the lower limbs are of great socioeconomic importance. The average age of patients is 38.5 years and the percentage of male patients is just under 64%. The highest prevalence of leg fractures in men is found in the age group between 10 and 20 years, while in women it is in the age group between 30 and 40 years. Intramedullary nail osteosynthesis is the surgical gold standard.
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