(Disclaimer: This article is for scientific use only, and the relevant information in the following content has been processed in order to protect patient privacy)
Abstract: Before being admitted to the hospital, 30-year-old Ms. Li accidentally fell at home mopping the floor and injured her hip, which immediately became painful and was not treated at that time, and then came to our hospital for consultation. Through examination and the patient’s symptoms, she was diagnosed with a minor sacral fracture that did not require surgical treatment and could be treated with bed rest, so the patient was given cold compresses and medication for analgesia, and bed rest was arranged. After a series of treatments, the patient’s fracture healed and her pain symptoms were relieved, and she was discharged successfully.
Basic information】Female, 30 years old
Disease Type】Sacral fracture
Hospital】The First Affiliated Hospital of Zhengzhou University
Date of Consultation】September 2019
Treatment plan】General treatment (manual repositioning, cold compresses) + medication (ibuprofen chewable tablets) + bed rest
Treatment Period】Hospitalization for 20 days, review after half a month
Treatment effect】The fracture has basically healed
I. Initial consultation
Ms. Li, 30 years old, was mopping the floor at home and fell down inadvertently because the floor was not dry and slippery, and she felt strong pain and swelling in her hip. When the patient was seen, he reported that he was in pain but was able to walk with the support of his family. On examination, swelling of the hip was found and a sacral fracture was suspected. Therefore, the patient was allowed to complete CT and MRI examinations, which showed that the patient had a fracture in the sacral area with a slight dislocation of the caudal vertebrae and no other abnormalities. Combining the patient’s symptoms and the examination results, it was clear that although the patient had a fracture, the injury was not serious, and the patient could rest in bed after the dislocation was repositioned manually.
II. Treatment process
After the diagnosis was made, I informed the patient and his family that the patient’s injury was not serious and did not require surgical treatment, and that pain relief with medication would be sufficient. In view of the patient’s unbearable pain, the patient was given ibuprofen chewable tablets to relieve the pain due to the sacral fracture. Afterwards, the patient’s caudal vertebrae were manually repositioned and cold ice packs were given to constrict the blood vessels in the buttocks to relieve the swelling and fever in the buttocks, which could also relieve the pain caused by the sacral fracture to a certain extent. In addition, the patient was told to rest in bed to avoid affecting the healing of the fracture or causing painful symptoms.
III. Treatment effect
After the use of pain medication and ice, the patient’s pain and swelling were significantly reduced, but there was still a slight pain when moving around. After 20 days of hospitalization and bed rest, the CT scan showed that the fracture was mostly healed, and after half a month of rest at home, the fracture was completely healed and the patient’s pain and swelling disappeared. However, nausea, vomiting and abdominal pain existed during the medication. I told the patient that this was a common adverse reaction to ibuprofen chewable tablets, and that the drug was irritating to the gastrointestinal tract, so it was recommended to take the medication after meals if you wanted to avoid or relieve this discomfort.
IV. Precautions
I was sincerely happy to see the patient discharged from the hospital after healing. When the patient left the hospital, I gave him discharge instructions and advised him to take common precautions after discharge, mainly including the following points.
1, the patient should take more rest in daily life, preferably bed rest for half a month, during which he can be appropriately active, but should not engage in overly strenuous exercise or overexertion, and avoid sitting or postures that compress the sacrum.
2.Patients should pay attention not to eat spicy and stimulating food in their daily diet, such as chopped fish head, spicy hotpot, etc., and carbonated drinks such as Coke and Sprite, so as not to affect the recovery and healing of the fracture.
3, usually you can eat some high-quality protein food, such as milk, eggs, etc. You should also eat foods rich in dietary fiber to promote intestinal peristalsis to avoid constipation and other conditions, which will lead to pain at the fracture site due to constipation.
V. Personal insight
When encountering patients with painful symptoms due to trauma, patients want to eliminate their pain symptoms as soon as possible. At this time, we should give comfort, find ways to quickly figure out the cause of pain and the severity of the condition, and then quickly give the patient pain relief treatment to relieve the patient’s pain and calm the patient’s emotions. In addition, during the examination, it is important to find out whether the patient has any other injuries in other parts of the body, and if so, they should be treated promptly. It is also necessary to inform the patient that the fall injury should not be taken lightly. Although the patient in this case was lucky that the fracture was not serious, it cannot be ruled out that some patients may have combined multiple fractures as a result of the fall injury. Therefore, once pain, swelling and other uncomfortable symptoms appear after a fall, you should go to the hospital promptly for early treatment after clarifying the specific situation.