This section of the website will be formed from the diary I keep for my own portfolio and learning needs as I develop as a Trainee Advanced Clinical Practitioner. I will add all the resources I come across to help me in my learning and hopefully you can benefit too.

Calf laceration and the Gastrocnemius muscle. LeForts Fracture.

Again two patients in particular had learning points for me to focus on.

The first patient was a boy who had  lacerated the back of his left leg. There were no other injuries and it just required suturing.

The depth of the wound was partial to full thickness which refers to the dermal layers and there was no muscular or tendon involvement which may have been of more concern. The practitioner I was working with also tested the Achilles tendon to ensure that that was not involved. This involved something called the Simmonds test which involved the patient kneeling on a chair and the practitioner squeezing the calf to ensure that the foot will still plantar flex.

From an anatomy point of view the muscle involved was the gastrocnemius muscle

Gastrocnemius-Muscle

 

The next patient was a gentleman who had  fallen to the ground. He presented with pain in his left hip a swollen and closed left eye and superficial skin injuries to his thumb.

I took a full history from this patient but when reflecting with my supervisor I perhaps needed to focus a little bit more on the mechanism of the fall and exclude such things as loss of consciousness, dizziness, chest pains etc.

This was towards the end of our shift so the patient was sent for an x-ray of his hip and I did not stay for the outcome of this x-ray. I need to follow this up when next back at work.

Another learning point which came out of this particular patient was the possibility of LeForts fracture in his face due to the nature of his fall. There all 3 possible types of Le Forts fractures depending on the mechanism of the injury and as a consequence they all have slightly different signs and symptoms.

Le Fort Fracture

This was excluded after examination. From discussion with my supervisor there was no pain around his eye on palpation and there was no sub conjunctival haemorrhage.

Le Fort fracture of the skull- Wiki

Originally posted 2014-10-17 11:45:10. Republished by Blog Post Promoter

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