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Distal Tibia Fracture with fracture blisters... Help needed.

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  • Distal Tibia Fracture with fracture blisters... Help needed.

    It's been awhile since I have posted here. My husband is a T11 complete Asia A 10 years post injury. He has fallen out of his chair numerous times and sustained tibial and femur fractures on his right leg, which were treated successfully. He fell out of his chair yesterday (when I was not home) and sustained a probably distal tibial fracture on his left leg. I am seeing multiple fracture blisters over the site of the fracture. He is refusing to go to the ER and wants to wait to see his
    ortho doc on Monday AM.

    I know the feeling from the ortho people is to wait until the blisters resolve before doing the surgical repair. This fracture is a closed one thank God. But I think he has sustained multiple fractures on this tibia both distal and mid front.

    My question is: Do I cover the blisters? I know they need to be kept intact if at all possible. If they do break... do I keep the overlying tissue or to we take it off and treat it?

    Any advice would be greatly appreciated.

    Thanks,

    Sieg

  • #2
    Orthopedic surgeons have evening and weekend call for their patients. Consider calling his or her answering service and have the on-call doctor paged. Follow their advice.

    If you don't want to do that, you can probably put a loose gauze dressing like Kerlix over the blisters to keep them covered until Monday. If the blister pops, don't pull off the skin by yourself.

    But, again, I'd really suggest calling the Orthopedic Surgeon's answering service tonight.

    I'm sorry you're husband is going through this. It's one of my biggest fears every time my husband transfers or rolls over uneven surfaces.

    Comment


    • #3
      Thanks 2drwhofans. My husband has no fear and he does what he wants... I am his caregiver but he is essentially independent. This fracture occurred when his lift did not work and he took himself and his chair down a flight of deck steps, holding onto the rails. I think he fractured his leg trying to get back into his chair but he couldn't tell me. He called the fire department and they came and put him back into his chair. The good news if that he is a T11 complete and can't feel the fracture. And he has not had any symptoms of AD. I have the leg immobilized when he is up in his chair but he has been resting alot this weekend in anticipation of his visit to the surgeon on Monday. Yes... we could call the orthopod on call but, having been through this before, I know they will delay any surgery until the fracture blisters resolve. Thanks again for your feedback!

      Sieg

      Comment


      • #4
        Any advice from the Carecure nurse??

        Comment


        • #5
          How is your husband doing?

          Comment


          • #6
            Thanks for asking... We saw the orthopod today and they won't even consider surgery until the fracture blister formation heals... Which I suspect will be a few weeks. They x-rayed the leg and the fractures are both tibial but actually pretty well aligned. But lots of soft tissue damage and in a para... That's not good news. So... Now it's a waiting game. We are bracing the leg and Don is able to be in his chair... I would like to avoid surgery if at all possible... He is 70 years old. Thanks again for your concern...I will keep you posted...

            Sieg

            Comment


            • #7
              Glad he is getting the care he needs.
              My questions are in the vein of prophylaxis. What is his Vit D level? What the reason he is falling out of his wheelchair?

              pbr
              The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

              Comment


              • #8
                Originally posted by SCI-Nurse View Post
                Glad he is getting the care he needs.
                My questions are in the vein of prophylaxis. What is his Vit D level? What the reason he is falling out of his wheelchair?

                pbr
                Thanks pbr:

                My husband is 70 years old and is 10 years post injury. He has a devil may care attitude which gets him into trouble. He is extremely active. The reason he fell out of his chair this time is: his lift from the kitchen door failed. So he decided to take the deck chairs down. He hung on to the railing and navigated down the stairs backward ( which, unbeknownst to me, he had done before successfully). This time, however, he flipped the chair and fell. I wasn't home and he tried to get back into the chair for about an hour, unsuccessfully and falling multiple times doing thus. He finally was forced to call the fire department and they put him back in his chair.

                I don't know what his vit d levels are. He's outside all the time, he uses his standing frame. He mainly eats well.

                My questions relate to the management of his fracture blisters... Any tips, suggestions???

                Sieg

                Comment


                • #9
                  Originally posted by ergvepeog View Post
                  Thanks for asking... We saw the orthopod today and they won't even consider surgery until the fracture blister formation heals... Which I suspect will be a few weeks. They x-rayed the leg and the fractures are both tibial but actually pretty well aligned. But lots of soft tissue damage and in a para... That's not good news. So... Now it's a waiting game. We are bracing the leg and Don is able to be in his chair... I would like to avoid surgery if at all possible... He is 70 years old. Thanks again for your concern...I will keep you posted...

                  Sieg
                  You might ask the orthopedic surgeon to prescribe a bone stimulator. They can help speed up healing especially when there are problems. The treatments are easy and self-administered at home. They are covered by Medicare and most insurances. I have used them on my last 2 femur fractures and they healed well. See the webpage below for more info.

                  http://www.exogen.com/us
                  You will find a guide to preserving shoulder function @
                  http://www.rstce.pitt.edu/RSTCE_Reso...imb_Injury.pdf

                  See my personal webpage @
                  http://cccforum55.freehostia.com/

                  Comment


                  • #10
                    got to wait 90 days for medicare to pay for one, just got mine........what are bone break blisters?

                    Comment


                    • #11
                      fracture blisters occur when the skin overlaying the bone fracture is so thin that the body counters the injury by developing blisters. Depending on how deep the soft tissue damage is, the blisters can either be clear or blood blisters. The key is to keep
                      them from breaking, as they are sterile when not compromised. Unfortunately, they do tend to rupture and then develop into pressure ulcers if not treated.

                      Update: One of Don's blisters ruptured today and it doesn't look good. I made an appointment with a good wound care center with an infectious disease MD for next Tuesday. In the meantime, I am keeping the area clean and covered.

                      Sieg

                      Comment


                      • #12
                        I would get a vitamin d level - it is very common to be low in elderly people. Please get supplements, there are studies that say that vitamin d replacement helps with falls. You need to work on preventative measures so these falls don't continue to happen.

                        See a wound care specialist about the blisters

                        pbr
                        Last edited by SCI-Nurse; 05-21-2015, 07:41 AM.
                        The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                        Comment


                        • #13
                          Originally posted by airart1 View Post
                          got to wait 90 days for medicare to pay for one, just got mine........what are bone break blisters?
                          Must be a new policy. I got mine within 2 weeks post injury.
                          You will find a guide to preserving shoulder function @
                          http://www.rstce.pitt.edu/RSTCE_Reso...imb_Injury.pdf

                          See my personal webpage @
                          http://cccforum55.freehostia.com/

                          Comment


                          • #14
                            Hi Everyone! Update from the land of tibial fractures and fracture blisters. We saw the wound people today for an initial consult.They want to do an ultrasound on the leg to R/O DVT. Don has a history of this. I suspect that he fractured his ankle as well and we will have that imaged next week.No Debridement needed on blister sites. Wounds are healing well. I am hoping we can avoid any surgery on the leg... but we shall see. We were told to use Xeroform on the sites QOD. And will be rechecked in a week.

                            Comment


                            • #15
                              Thanks for the update. I hope he heals well.

                              Comment

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