History :
A 23-year-old woman arrived at the hospital of Spine Fracture Specialist in Pune Dr. Sangram Rajale after reportedly falling from the sixth floor and losing consciousness at 11 am on 28/10/2023. She presented with ankle deformity and experienced upper, middle, and lower back pain. Additionally, she exhibited reduced leg power and sensation following the fall. Despite being brought to the hospital approximately 16 hours later, further examination revealed multiple rib fractures and severe liver injury, along with an ankle fracture from the 70-foot fall.
The patient was admitted to the Surgical Intensive Care Unit (SS ICU) on 28/10/2023 under Spine Surgery Specialist in Pune Dr. Sangram Rajale due to multiple liver lacerations, hemothorax, and multiple rib fractures, and fractures were observed. After being deemed stable on 10/11/2023, she was transferred to the orthopedics ward for further care.
Radiological Investigations:-
X-RAY OF PELVIS WITH BOTH HIP JOINTS (29/10/2023)
The patient has a mildly displaced fracture of the coccyx and lower right sacral ala, with normal architecture in other bones and normal sacroiliac and hip joints. Additionally, there is a burst fracture of the L1 vertebra, along with mildly displaced fractures of the transverse processes of L1, L2, and left L3 vertebrae, and a mildly displaced avulsion fracture of the coccyx.
Furthermore, an X-ray of the right ankle on shows a suspicious undisplaced fracture of the talus with medial subluxation of the tibiotalar joint, a suspicious undisplaced fracture of the navicular, and a suspicious comminuted fracture of the base of the 5th metatarsal
Operation :
On 6/11/2023, the patient underwent minimally invasive surgery involving D11-L3 percutaneous posterior spinal fixation along with open reduction internal fixation using Herbert screws for the right talus. The procedure was performed under general anesthesia by Best Spine Surgeons in Pune Dr. Sangram Rajale.
Condition On Discharge :
After the surgery by Orthopedic Spinal Surgeon in Pune Dr. Sangram Rajale , the patient did not show immediate improvement and was discharged from the hospital on day 15. Following discharge, she adhered to aggressive physiotherapy as advised. Over time, her muscle power began to recover. By the end of 3 months, she was able to stand independently without any support, which was a significant milestone for her. By around 6 months, she achieved the ability to walk independently without any support, which brought her great joy.
However, her ankle fracture did not heal as expected, leading to a limp while walking. A plan will be developed to address this issue and treat the ankle fracture promptly.