Knee Injury Medical Treatment - Case Study Example

Patient D. Age: 24 years. Female.The patient is a young lady brought in by friends after having dislocated her knee cap in a sport event. The patient is in pain and cannot walk. She can talk and gives consent for examination and care (Greaves and Johnson 2002, p.74). She also gives her own history.PC: Dislocated knee cap, swollen and painful knee joint. Consistent throbbing pain.HPC: The patient was well until 1 hour ago when she dislocated her knee joint in a football game at the college. She was fell and hit the pitch on her right knee and dislocated.

She reports consistent pain and the knee began to swell from that time (Quigg et al. 2013, p. 385).PMH: Normal childhood with no major illness. Two sports related minor injuries, radial fracture and wrist tendinitis at ages 14 and 17 respectively. All corrected with normal recovery.Weight: 60.3kgMedication: The patient is not on any medication, prescribed or otherwise.Allergies: There is no known history of allergy to foods or drugs.Immunisation: Completed the immunisation schedule; up to date for her age.

SH: the patient is the first born in a family of three siblings. Lives with the parents and two brothers. She is in college and is a sportswoman has been playing football since elementary schools, it has become her hobby as well as the reason she obtained a scholarship in the college. Her mother is a nurse while the father works as lecturer at a local college.O/E: The patient appears to be in pain (Davies et al. 2011, p.8). The knee appears deformed. The patella bone is visible towards the inner side of the thigh, medial and superiorly to the knee joint.

Cannot move the affected leg which have started to swell around the knee joint. She is literary guarding any attempt to touch the affected leg.ROM: There is intense pain in each movement of the knee joint affected by the injury. Active: Flexion- Intense and unbearable painExtension: intense pain Abduction-, intense painAdduction- intense painMedial Rotation- intense painPassive: Flexion- intense painExtension- intense painAbduction- intense painAdduction- pain free movementMedial Rotation- intense painResistive: intense painExtension- intense painAbduction- intense pain Adduction- intense pain Medial Rotation- intense painPhysical assessment shows no other abnormality.

Impression: Total Right knee-cap dislocation.Plan: Immobilise the knee joint. Prepare for x-ray to identify the position of the patella. Apply strong anti-inflammatory agents to reduce swelling. Prepare patient psychologically for manual stabilisation. X-ray Results: Displaced patella, medial superiorly with a torn patella ligament.Treatment: Manual stabilisation and positioning of the patella. Cast application. Analgesics and anti-inflammatory agents application to relieve pain and inflammation (Steele & Singh 2012, p. 273). Weekly clinic visits for follow-up for the first one month then cast removal after 6 weeks.

Advice: Minimum movement of the knee and the affected limb for the first six weeks. Observe for compartment syndrome which could be evidenced by stiffness and loss of sensation for the art distal to the cast. Keep the cast clean and dry and ensure the inside of the cast does not get wet. Strength training after cast removal (8 weeks).Avoid immediate return to extraneous exercise for at least six months to allow complete healing of the torn tendons. Be careful in games, recurrence is common. AbbreviationsPC- Presenting ComplainHPC- History of Presenting ComplainKg- KilogramPMH- Past Medical HistorySH- Social HistoryO/E- On ExaminationNAD- No Abnormality DetectedROM:- Range of MotionReferencesDawood, M. (2012) The Emergency Practitioner’s Handbook: for all front line health professionals.

London: Radcliffe PublishersDavies , F. Bruce, C.E. and Taylor-Robinson, K.J. (2011) A Pratical Handbook: Emergency Care of Minor Trauma in Children. Uk: Hodder Arnold an Hachette Uk CompanyGreaves, I. & Johnson, G. (2002) Practical Emergency Medicine. London: Arnold Publisher.Steele, H.L. & Singh, A., 2012. Vascular injury after occult knee dislocation presenting as compartment syndrome. Journal of Emergency Medicine, 42, pp.271–274.Quigg, Z., Hughes, K. & Bellis, M.A., 2013. Effects of the 2010 World Cup football tournament on emergency department assault attendances in England.

European Journal of Public Health, 23, pp.383–385.