Tuesday, November 16, 2010
Back to the ER. Another guest appearance by me at an ER near you! This fracture is what happens to you if you are playing football in an asphalt parking lot wearing flip flops.
But first you need to be very heavy. Then you need to be intoxicated. Then you need to jump over a curb to catch a ball and land, with all your substantial weight, directly on the ball of your foot. That 'CRACK' and 'SNAP' you heard (before you collapsed on the ground in pain) were various bones and ligaments in your mid-foot being broken and ruptured.
This is a really bad fracture to get as, even with surgery, the foot is just never the same. We were able to 'reduce' this fracture by giving the patient propofol and putting him in a happy place for a few minutes while the Orthopedist and I pulled and pushed on his foot to get the dislocation 'un-dislocated', or, in doctor terms, 'reduced'. As soon as this is done a substantial amount of pain is relieved. This patient went home on crutches but will need surgery. The lisfranc fracture, don't get one.
* what i have attempted to show in the Xray above is that the metatarsal bones, the long bones in the upper portion of the Xray, are displaced to the left of the tarsal bones. There are also various small avulsion fractures that did not transfer well to this cell phone image.
Posted by 911DOC at Tuesday, November 16, 2010