What is the treatment for arm fracture and rib injury?

Hi,

Welcome to icliniq.com.

As per the reports (attachment removed to protect patient's identity) submitted, I understand that it was a major accident. She has multiple injuries to various parts. Usually, with such injuries, it is difficult to isolate each problem and provide a solution without seeing the patient as multiple organs are involved.

As it has been 10 days since her accident, I assume that she is clinically stable by which I mean that her pulse rate and blood pressure are normal or near normal.

Both the bones are fractured in her arm. So, an internal fixation (installing plate) done by operation would be ideal. For the shoulder, I cannot make out any fracture which needs surgery. Anything minor can be managed by support and strapping for clavicle.

Chest pain and breathing problem will be there due to multiple rib fractures. CT suggests minimal blood in the thorax. She will require chest tubes (which might already have been put) on both sides, but the decision is clinically based.

High dose analgesics (painkillers) will be required for the pain, to help her breathe. Also, she may require ventilatory support for the sometime as she may not be able to breathe well due to the pain.

I could not see any report suggesting blood clot in the veins whether it is in the upper limbs or lower limb. If it is associated with the fracture in the upper limb, then the best treatment is surgical removal during fracture fixation.

Lower limb clot also may need surgery based on the extent of involvement, and it is a clinical decision. It is usually done at the earliest. As it has already been 10 days since the accident, I do not understand which clot they are talking about.

Remaining supportive care is going on as required as you have written. Her last hemoglobin was 8.3. I believe she was given blood transfusions after that. If not, she needs blood transfusion too.

Hi,

Welcome back to icliniq.com.

I think she still needs some treatment. If she is stable she can be shifted but will need to be shifted in an ambulance with precautionary measures. She will require hospital care for more time which can be obtained at her place too.

No, chest pain and breathing problems are due to the rib fractures. If there was blood in the chest the doctor would have put in chest tubes, which helps improve the breathing.

There is a small controlled tear in the aorta (blood vessel supplying to all parts of the body), which may require monitoring now and assessment at a later date to see if it requires any surgery.