Delayed Treatment of Proximal Tibial Comminuted Fractures - Orthopedics

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Delayed treatment of proximal tibial comminuted fractures can lead to a range of complications and adverse outcomes. In your relative's case, the delay in seeking medical attention for the left proximal tibial fracture until July 7, after the accident on May 26, raises several concerns.

Firstly, it is important to understand that a comminuted fracture, which involves the bone being broken into multiple pieces, can lead to significant swelling, pain, and instability in the affected area. The initial symptoms following such an injury typically include severe pain, swelling, bruising, and difficulty bearing weight on the affected leg. In some cases, there may also be visible deformity or abnormal positioning of the limb.

Regarding your question about fever, it is possible for a person with a significant fracture to experience a low-grade fever, particularly if there is associated soft tissue injury or if the fracture is open (exposed to the environment). Fever can be a sign of inflammation or infection, especially if there is any compromise to the skin or underlying tissues. However, a fever is not a common symptom directly associated with a closed comminuted fracture unless there is an underlying infection or other complications.

Delaying medical treatment for a fracture, especially a comminuted one, can lead to several complications. These may include:
1. Nonunion or Malunion: The fracture may heal improperly, leading to chronic pain and dysfunction. Nonunion refers to the failure of the bone to heal, while malunion refers to healing in an incorrect position.

2. Infection: If the fracture is open, there is a risk of infection, which can lead to serious complications, including osteomyelitis (bone infection).

3. Compartment Syndrome: This is a serious condition that can occur when swelling from the injury increases pressure within the muscle compartments of the leg, potentially leading to muscle and nerve damage.

4. Joint Stiffness and Loss of Function: Prolonged immobilization or lack of movement can lead to stiffness in the knee joint and surrounding muscles, making rehabilitation more difficult.

5. Chronic Pain: Delayed treatment can lead to chronic pain conditions, such as complex regional pain syndrome (CRPS), which can be debilitating.

In general, it is not advisable to delay treatment for a significant fracture like a proximal tibial comminuted fracture. The standard of care typically involves prompt evaluation and management, which may include imaging studies (like X-rays or CT scans) to assess the extent of the injury, followed by surgical intervention if necessary. Surgery may involve internal fixation with plates and screws or external fixation, depending on the fracture's complexity and stability.

In conclusion, while it is understandable that financial constraints can impact access to medical care, it is crucial to seek timely treatment for significant injuries like fractures. Delaying treatment can lead to complications that may require more extensive and costly interventions later on. If your relative is experiencing ongoing symptoms, it is essential to consult with an orthopedic specialist as soon as possible to evaluate the injury and determine the appropriate course of action.