A Case Study Femur X Ray

Femur X-ray

Greg, a 58-year-old man, was presented complaining of intense pain on the upper side of his right leg and could barely walk. His medical history was recorded, with the most relevant being that Greg has undergone treatment for Hepatitis B, specifically using adefovir dipivoxil. He also had a six-month history of bone pain (Tanaka et al., 2012). Preliminary diagnosis necessitated a femur x-ray to establish possible fractures and open reduction and internal fixation (ORIF). Anteroposterior femur view was essential for an entire femur examination (Murphy & Jones, 2017). To achieve an accurate inclusion of the hip and knee joints. The femur x-ray identifies any foreign bodies, fractures, and dislocations with this view. Besides, this procedure would come in handy in case of prosthetic needs. During imaging, Greg was put in a supine position. The image detector was placed diagonal, ensuring that it remained parallel to the femur. Since fracture was suspected, the standard approach of rotating the lower limbs was avoided. Only minor rotations were made through assisted sandbags. 2APs and two laterals were done to capture the entire anatomy and look for injuries or pathology. Radiographic examination of the images revealed that Greg had life-threatening femoral shaft fractures (Tanaka et al., 2012). A further diagnosis was made to rule out the possibilities of ipsilateral fractures.

The results were positive, but it was clear that Greg required ORIF. A section of the upper side required nailing because it was broken, and the lower part required open reduction to align the fractured bones. The fracture pattern was oblique, which resonated with the pathological effects of Hepatitis B mainly due to Osteomalacia (Tanaka et al., 2012). From Greg’s medical history, he had been treated with lamivudine, and the Hepatitis B virus had become resistant. The pathological fractures also depicted possibilities of Fanconi’s syndrome, which is closely linked to adefovir therapy. Greg appeared to have concealed some more information, and we had to deeper examination to properly address the femur injury. Accordingly, preoperative procedures were conducted through arthroplasty. Results indicate minor platelet aggregation. We responded by conducting platelet transfusion. To conduct ORIF, Greg underwent anesthesia. The fixation process used K-wires, Kirschner, and rods to stabilize the bone. Most of these orthopedic implants were designed to remain permanently in the body, but the k-wires on the lower parts of the femur were temporarily designed to support the bone until it heals (Jonathan Cluett, 2021). However, Greg had to be on crutches until the bones developed enough support. Greg was also scheduled for post-operative care through physical therapy that would help his bones restore their strength, motion, and endurance. Immobilization would mean intensified limb complications. Greg underwent surgery to allow internal fixation and get samples of the bone tissues.

For Hepatitis B, Greg was advised to continue with his medication. However, for the femur fractures, Greg received and Villanueva–Goldner counterstain and Villanueva bone stain. It was clear that despite Greg broken femur due to a minor accident, the fractures were primarily caused by Osteomalacia. His femur was weak and vulnerable. This placed Greg at a higher risk of other infections, needing more preventive measures. The ORIF procedure poses risks, such as possible bacterial infection, compromised motion, arthritis, and nerve damage. It is necessary to note that the internal fixation of the femur subjected Greg to a risk of shortened limb, which could constitute more complications. Accordingly, Greg was put on a weekly medical check routine to ensure no related complications arose. These check-ups were also crucial due to Greg’s age. Healing was expected to take slightly longer due to other post-exposure effects, specifically the Hepatitis B virus.