Hillcrest Medical Complete Case 9
1586 words 7 pagesHISTORY AND PHYSICAL
Patient Name: Marilyn Sue Stone
Patient ID: 116588 DOB: 01/24 Age: 50 Sex: F
Room No.: 181A
Date of Admission: 02/07/2012
Admitting Physician: Jessie D. Smith, MD of Orthopedics
Admitting Diagnosis: Chronic Hip Pain
HISTORY OF PRESENT ILLNESS: Patient is a candidate for a total right hip revision. She has 2 units of directed packed red blood cells. It is not autologous. She does had Hepatitis B. She has arthrogryposis. She had a right total hip replacement many years ago by Dr. Dodd at the University of Miami. She has had multiple other surgical procedures as follows. A: She had bilateral foot surgery In the remote past. B: She had left hip surgery a year ago. C: She had right foot …show more content…
It fit very well. Allograft bone graft was morselized. A piece of femoral head allograft was placed on the acetabular defect then allograft cancellous bone chips were packed into the defect. We then inserted the contour retention cage it was fixed to the wing of the illium using 4 screws. We also put a screw inferiorly, this construct was quite stable. Methyl methacrylate cement was used to cement the 46mm cup into the cage. Excellent fixation was obtained.
Attention was then turned to the femur. A trochanteric osteotomy was performed to mobilize the shaft of the femur. All cement was removed from the femoral canal. The femoral canal was willing to accept a 12 mm stem. The stem was 12mm by 100mm with a 15mm build up. We hammered this down into position it was very stable. A plus 8 of 28mm head was applied. The hip was relocated. This restored leg length measurements from the anterior brim of the pelvis. The osteotomized trochanter was reattached to the shaft of the femur. The anterior 1/3 of the gluteus meduis/minimus was repaired back to the trochanter using No.1 vicrol. The IT band was closed using No.1 reinforced with a double arm No.1 PDS suture.
Subcutaneous tissue were closed with O vicril. And the skin was closed running with subcutenular ______. A compression dressing was applied, and the patient was taken to a PACU in good condition. Estimated blood loss was 300mL, none