In a road accident my friend died and his 8 yr old daughter injured, and now she is unable to move lower limbs.(Paralyzed)
This accident happened in india, here are some paragraphs i picked from here diagnosis report.
Please kindly need advice on treatment options available here in US.
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Diagnosis: Unstable Ts + Tc Thoracic vertebra fracture with traumatic
paraplegia with neurogenic bladder.
Left orbital floor blow - out fracture, L7-MC complex fracture.
Bilateral nasal fracture.
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Surgery: Stabilisation of thoracic vertebrae fracture with
instrumentation & fusion.
ORIF of facial fractures.
Clinical Examination
Weight : 30 Kgs
CVS : S1 52 normal, no distant heart sounds
RS : Air entry decreased over right side.
ABDOMEN : Soft, distended, mild tenderness.
CNS: Patient Awake but drowsy.
DTR - Not elicitablein lower limbs
GENITALS : Normal.
GENERAL APPEARANCE : Skin - Lacreation + over left eye & base of nose
Eyes - Swelling left eye +.
Ears - Normal.
Nose - No bleeds.
Mouth - Blood clots +.
Throat - Normal.
Neck- Normal stabilized with collar.
Functional evaluation(ability to do routine activities:)Not able to move lower limbs.
Unstable T5 + T6 Thoracic vertebrae fracture with traumatic paraplegia.
MRI spine done showed burst fractures at T5 + T6 with retropulsion of the fracture
segments narrowing the spinal cord & causing compression with resultant
paraplegia.
Surgery Done :- Stabilization of thoracic vertebrae fracture with instrumentation
and fusion.
Infection:
Patient was intubated & had sustained trauma she was started on emperic
antibiotic with eefaperazon & Sulbactam along with targocid as cultures were
sterile they were stopped . During her course of stay in hospital she developed
asymptomatic E.coli bacteria & was treated with Tab.Nitrofurantion (risk
factor- intermittent catheterization of neurogenic bladder) .
Currently she is on CIC for the same.
1. - Patient was shifted from PICU on ventilator.
-Shifted from bed to OT table, prone position without disturbing
vertebrae fracture.
-Back thoroughly washed. An area of about 5cm in diameter dark skin
region noted. ( ? Pressure sore )
-Under 1 .1 level marked.
-Posterior midline longitudinal incision Deep fascia incised.
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Thank you all very much for the helpful info.