Seeing that the artificial skin was successfully removed, it was determined that the fracture was reduced and fixed well, and the fetal heart rate in the womb was stable, and the 30-year-old pregnant mother Ms. Liu's hanging heart finally fell. Recalling the scene of the accident injury a week ago, the family still has lingering palpitations.
It turned out that on the day of the incident, Ms. Liu was planning to take the elevator with her family to go out, because the pregnancy has reached 30 weeks, the movement is relatively inconvenient, at the moment when the elevator is closed, Ms. Liu's right foot is accidentally stuck in the gap of the elevator, and suddenly there is a heart-rending pain, blood is like an infusion, and the frightened family members quickly dialed 120 emergency ** to send her to the nearby Yangtze River Shipping General Hospital Wuhan Brain Hospital for treatment.
Seeing this, the emergency physician immediately opened a green channel for examination, and preliminarily diagnosed Ms. Liu as an open fracture of the metatarsal of the right foot with active bleeding caused by trauma, and after preliminary bandaging to stop the bleeding, Ms. Liu was quickly transferred to the orthopedic department for further treatment.
It was found that under the gauze that had been infiltrated by blood, it was obvious that the dorsum of the right foot, which was partially defective, was still bleeding. Considering that the patient's pregnancy was not full-term, Yang Liu, an orthopedic attending physician, realized that the situation might be more complicated than imagined, and decisively reported the condition to the senior physician He Xuan, deputy director. "The patient's 1st to 4th metatarsal fracture of the right foot is significantly displaced, combined with an open wound on the back of the right foot, which requires immediate surgical internal fixation, and timely debridement and suturing of the wound!" "Tell the operating room to prepare for surgery immediately!" At the same time, an obstetrician and gynaecologist consultation is requested to evaluate the fetus. Under the organization of He Xuan, the multidisciplinary teams of the hospital's orthopedics, obstetrics and gynecology, and anesthesiology departments quickly assembled to conduct a consultation for Ms. Liu.
However, surgery or not? However, the choice of surgical method and anesthesia method once made it difficult for patients and their families. If surgery is not performed in a timely manner, the fracture may not heal or malunion, and the wound on the right foot may become infected, resulting in a long-lasting wound. However, precise surgical reduction often requires the help of C-arm fluoroscopy to accurately locate the anatomical reduction point, and fluoroscopy radiation has a certain amount of radiation for the pregnant fetus. After fully respecting the patient's right to know and communicating openly and honestly with the patient's family about the pros and cons of the operation, the professionalism and dedication of the multidisciplinary team were fully trusted by Ms. Liu and her family, and they highly agreed that the multidisciplinary team decided to adopt the surgical plan without the assistance of C-arm fluoroscopy, which requires higher clinical experience and technical level of the surgeon, but can protect the pregnant woman and fetus from the effects of radiation. "We are willing to take this risk with the doctors! Ms. Liu's family said firmly.
After sufficient preoperative preparation and combined spinal-epidural local anesthesia, He Xuan led the surgical team to successfully implement K-wires needle internal fixation of metatarsal fracture without fluoroscopy assistance + right foot wound debridement and suturing + artificial skin covering. Under the escort of the multidisciplinary team, Ms. Liu's vital signs and fetal heart rate were stable and safe, and she successfully passed the 5-hour high-risk observation period after surgery.
Accidental injuries are hard to prevent. He Xuan reminded the general public that during the Spring Festival, when going out to take the elevator in and out of the elevator to be particularly careful, when the elevator arrives, you should wait for the elevator to stop completely before entering the elevator, and pay attention to your steps to avoid stepping on the air or being caught by the ladder door. In addition, he pointed out that pregnant women, children and the elderly should pay special attention when taking the elevator, and it is advisable to find specially designed aisles or waiting areas. In the event of an accidental injury like a patient causing an open wound, it is best to compress the bleeding first and call for help in time**. In case of severed fingers, limbs, etc., it is necessary to properly store the severed object in a dry low-temperature container (about 4 degrees Celsius), and send it to the doctor for surgery within 6 hours as soon as possible.
Reporter: Luo Bing Correspondent: Zhou Shan.
Editor: Wang Jian.
Editor-in-charge: Summer.
Editor: Wang Jun.