The impact of an accident from a high-speed vehicle tends to be devastating to the victims, and the injuries sustained can easily be life-threatening. Mr. Parker (not real name) was brought to the hospital after suffering a fractured femur and broken ribs from a high-speed Motor Vehicle Accident (MVA). Mr. Parker appeared to be in great pain and could not stand on his own due to the degree of the fractured femur. Additionally, he experienced difficulties breathing and complained of a lot of pain in the chest. Mr. Parker was a 32-year-old male taxi driver who had not gotten involved in a motor vehicle accident before. Furthermore, his medical records did not indicate any history of a fractured femur. However, Mr. Parker had previously suffered fractured ribs from severe coughing; although the injury was mild, he recovered without medical intervention. Many mildly fractured ribs tend to heal naturally within six to twelve weeks (Bauman et al., 2021). Breathing exercises and chest-stretching exercises tend to be effective in healing broken ribs.
Mr. Parker’s fractured femur caused significant blood loss; part of the emergency intervention was to stop the bleeding. Femur fractures tend to cause life-threatening bleeding especially when the muscles around the bone are damaged (Doğan et al., 2022). Although the femur is one of the strongest bones in the body, the impact of a high-speed MVA releases intense physical forces that are strong enough to break it. Moreover, these forces can cause the rapturing of blood vessels and muscles surrounding the femur. The damage caused to the blood vessels causes significant bleeding that can be fatal. It is estimated that a close femur fracture can lead to about 1500ml loss of blood (Doğan et al., 2022). However, this figure is often higher when the fracture is open. In the case of Mr. Parker, the fractured bone did not protrude from the skin, although an open wound exposed broken bone.
The paramedics applied the prehospital intervention to aim at stopping excessive bleeding. The vital steps to control external hemorrhage include applying direct pressure on the injury. Direct pressure is essential in cutting off blood supply to the affected area (Curtis et al., 2019, p. 1195). The limb was elevated above the heart level to reduce blood pressure, hence slowing blood flow to the affected area. Additionally, the wound was dressed to reduce the bleeding and the exposure of the injury to pathogens. Hemostasis is one of the vital processes to which accident victims who have suffered femoral fractures tend to be subjected (Fujita et al., 2022). In addition to hemostasis, Mr. Parker was subjected to analgesia to reduce the pain caused by the femur fracture. The femoral injury is considered one of the most painful fractures that negatively impact the patient’s recovery (Mitchell et al., 2018). Pain tends to increase physiological stress, influencing high breathing and heart rates (Zubrzycki et al., 2018). High breathing rates tend to increase the demand for oxygen to vital organs (Zubrzycki et al., 2018). As a result, a shortage of oxygen and vital nutrients leads to headaches, confusion, and restlessness in the patient.
Mr. Parker’s chest was iced to reduce the pain caused by the fractured ribs. Additionally, he was provided with adequate analgesia to reduce the chest pain. Although the ribcage injury was not severe, the intense pain would affect his recovery. Due to the mildness of the rib injury, it was not given much attention. The mechanism of injury (MoI) for the fractured ribs was caused by the grip of the seatbelt that held back Mr. Parker during the impact. Moreover, the injury may have been influenced by the impact of the airbags and Mr. Parker’s chest during the accident (Hernandez et al., 2019). The vehicle’s crumpling influenced the injury mechanism for the femur fracture during the impact. Mr. Parker’s vehicle swerved and hit a roadside signpost causing the front of the vehicle to crumple. The crashing caused physical forces that stressed the femur of his right leg, thus causing a displaced fracture. This type of fracture is caused when a bone is broken into two such that the two pieces cannot align (Lewis et al., 2019). The high speed influenced the degree of both injuries that the vehicle was being driven at the time of the accident.
The pathophysiology of femur fractures involves breaking the femoral bone due to trauma. In most cases, the degree of the fracture tends to be influenced by the strength and quality of the bones. Some common factors that contribute to the quality of the bones include bone mass and age (Zhu and Zheng, 2021, p. 54). Many people tend to attain the peak bone mass at 20 to 25 (Zhu and Zheng, 2021, p. 57). Bone mass is the volume of minerals present in a bone. High bone mass increases the density of the bones, thus preventing unnecessary fractures (Zhu and Zheng, 2021, p. 54). However, when the density of the bones is low due to reduced bone mass, one is likely to develop osteoporosis which increases the possibility of fracturing bones (Khosla et al., 2018). Additionally, young people tend to have more high-quality bones than the elderly. Considering Mr. Parker’s age and medical records, he had achieved the peak bone mass and did not have a history of osteoporosis or low-density bones. Therefore, the main cause of the injury was the crash’s impact, and no preexisting condition contributed to the injuries.
The assessment of the femur fracture and the broken ribs was conducted through an x-ray and a CT scan, respectively. The CT scan tends to be more effective in assessing rib fractures than X-rays. This technology can analyze the degree of the injury from various angles and scan other organs in the rib cage, such as blood vessels and lungs, to determine whether they were affected by the injury (Benmalek et al., 2021). It was necessary to conduct a CT scan on Mr. Parker to determine whether the fractured ribs had punctured the lungs, which could lead to breathing difficulties. However, the scan did not show any serious fractures. It was agreed that the icing of Mr. Parker’s chest and the analgesia administered earlier was sufficient to reduce the pain. It is advisable to avoid taking painkillers such as ibuprofen for at least 48 hours after the injury because such painkillers tend to slow the healing process (Weisz et al., 2020). The fracture Mr. Parker suffered could take at least six weeks to heal on its own.
The x-ray on Mr. Parker’s femur indicated a transverse fracture with the two pieces displaced. The leg right leg which was affected appeared to be shorter than the other and deformed. The degree of the injury was severe and risked attracting secondary infections considering it was an open injury. The x-ray scan on Mr. Parker’s left leg indicated no complications. Due to the trauma of the accident and the rib fracture, Mr. Parker was not deemed stable for immediate surgery. Instead, it was agreed that the leg is subjected to external fixation until Mr. Parker is stable for the surgical treatment. It was a priority to address the open wound, reduce the bleeding, and treat the ruptured blood vessels and muscles around the broken bone. The wound was treated with antibiotics to prevent the development of other infections. Meanwhile, the injured leg was placed on a long-leg splint to maintain the leg’s length and reduce the broken bones’ further deviation (Butler et al., 2018). The long-leg splint is essential in keeping the broken bones aligned.
The external fixation treatment was a temporary intervention aimed at holding the broken bones into position. It involves placing pins and screws on the lower and upper broken bones and attaching the pins to a bar outside the skin (Starr et al., 2018). This mechanism enabled the medical professionals to monitor Mr. Parker’s condition effectively and address other minor injuries he suffered from the accident. The patient had suffered excessive bleeding and portrayed psychological distress, which could affect his recovery from the surgery. Therefore, it was justifiable to use external fixation as temporary intervention for the femur fracture.
The pathophysiology of Mr. Parker’s femur injury involves a transverse fracture on the femoral shaft, which prevents him from standing or walking. Additionally, the injury makes it ineffective to hold any weight. Considering it was an open injury, the muscles around the affected bone were damaged, making them difficult to hold the leg in position (Saleeb et al., 2019). The injury tends to cause significant pain that must be relieved to reduce psychological stress that may affect the patient’s recovery and alter their overall performance (Nelson et al., 2021). A fractured femoral shaft can easily lead to the development of acute compartment syndrome. This condition occurs when increased pressure around the muscles of the affected area, thus reducing the supply of oxygen (Guo et al., 2019). This syndrome can lead to ischemia, where there is restricted blood circulation in the affected area, leading to tissue death.
The management of Mr. Parker’s condition requires close monitoring to ensure his recovery is effective and prevent potential complications. Evaluation of his condition should include physical examination to identify any issues that may affect his recovery. One of the potential complications of a femur fracture is the development of osteomyelitis. This serious infection occurs when the broken bones are not accurately aligned (Masters et al., 2019). Osteomyelitis can lead to amputation of the affected limb to prevent the infection from spreading to other body parts. Therefore, the wound must be cleaned regularly to kill any possible staphylococcus bacteria that can cause osteomyelitis. Furthermore, the patient should be taught self-management care to enable him care for himself efficiently and prevent developing complications. For instance, after the surgery, the patient should be taught leg exercises. Physical therapy is important in recovering from a fracture because it aims to restore muscle therapy and increase flexibility.
In addition to physical therapy, there is a need for the patient to be subjected to psychological counseling to reduce stress and enable them to accept their condition. Emotional stability is crucial in the patient’s recovery by maintaining normal physiological processes (Khan et al., 2018). Emotional stability should include maintaining close ties between the patient and his family. Close social relationships tend to reduce the amount of stress that the patient may develop. Reports indicated the accident caused a break failure on Mr. Parker’s vehicle. Therefore, he must seek legal action for compensation for the injuries suffered. However, it is advisable that he waits until he has fully recovered before taking legal action to reduce the emotional breakdown that tends to be caused by court cases (Khan et al., 2018). Lastly, the medical team attending to Mr. Parker must observe ethical considerations, including the patient’s confidentiality and autonomy (van der Pijl et al., 2021). For instance, all medical procedures should be acquainted with the patient before administration.
Although the management of Mr. Parker’s case was effective, there is a need to interrogate the pain management mechanism. Medical professionals should combine different pain relievers before resorting into opioids if the other methods failed (Elsevier and Cannada, 2020). Mr. Parker nearly developed opioid addiction that would have significantly affected his general welfare. Opioid drugs should be the last option for pain relievers to reduce the rate at which patients become addicts (Wang et al., 2019). Opioid dependency is becoming a crisis in the healthcare system hence the need to look for alternative options.
In conclusion, bone fracture is one of the major injuries caused by motor vehicle accidents (MVA). The femur is one of the most affected bones, and its injury can be life-threatening, especially if it causes excessive bleeding. The fracture is often caused by trauma that is propagated by physical forces. Additionally, the fracture can be caused by an intense impact between the bone and a physical object. This injury tends to cause significant pain that may affect the patient’s physiological processes. Therefore, one immediate intervention should be relieving the pain by administering analgesics. An x-ray should be conducted to determine the injury’s extent and appropriate treatment. The recovery process should include physical and psychological therapy to prevent the development of complications.
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