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Dr.Wagner -> RE: Case of the week Sept 4 (September 5, 2007 10:30:45 AM)
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Q:what about hip and back What about putting weight through the joint in non weight bearing, that is sending a longitudinal force through the foot while supine, what views were the X-rays? Did they rule outtalar dome fracture in the plantar flexed view?
A: Putting weight through the joint causes significant pain, which you were apprehensive to do anyway due to some significant swelling you are noting on exam. The xrays were standard views of the foot.
Q:The x-rays were negative for fractures? Besides the swelling, was there ecchimosis as well. How much weight could the female put on the affected foot?
A: At the Med Check facility (doc in a box)they were read as "negative". Yes, you begin to notice mild bruising. The patient cannot bear weight.
Q: How does she fall? With the foot stuck in stirrup? Or did she land on her foot?
A: The patient is unsure.
Q:Wags, was she wearing a helmet? ;) Was the horse standing, walking, trotting, galluping? Was she using a saddle? What kind of saddle? What did the horse do when she was no longer on it's back? If she wasn't wearing a helmet, did you yap at her about how she's lucky she didn't damage her brain? Did the horse step on her? Sorry... I'm all into mechanism of injury. :) I won't be able to focus until I can "see" what happened. And.. hey... was she wearing riding boots? What kind?
A: She was wearing a football helmet and carrying a trident. She had leather gucci boots from a sale at Saks and the saddle was made of fishhooks (which may have been why the horse disliked her so much). I discussed proper apparel with her, clearly the trident was too much.
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