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69-year-old female admitted to Logan Square Rehabilitation and Healthcare Center from Thomas Jefferson University Hospital, where she initially presented as pedestrian vs. car. Work-up revealed multiple closed fractures of facial bones, C6 inferior endplate fracture, minimally displaced left 5th metatarsal fracture, and pelvic fracture. Neurosurgery, Ortho Trauma, ENT, and OMFS were consulted. Pelvic fractures – non-operative management. Left fifth metatarsal fracture – continue CAM boot and NWB to left lower extremity. Facial fracture – continue sinus precautions. Spine fracture – stable without brace. Past medical history significant for cardiomyopathy, lumbago, COPD, anemia, HLD, migraine and HTN. Patient transferred to Logan Square Rehab for continued medical optimization and ongoing therapy services.
Medication Management – Amlodipine, Aspirin, Lidocaine patch, Ibuprofen PRN, Oxycodone PRN
Maintain Adequate Nutrition – Initially patient tolerating Puree diet with thin liquids. Diet advanced as tolerated. Patient tolerating regular texture diet with thin liquids.
Maintain Weight Bearing Status – Initially, she was NWB to left lower extremity in CAM boot.
While in-house, her weight bearing status was liberated to WBAT to left lower extremity and her CAM boot was removed.
Upon admission, she required assistance with mobility including Min A for transfers and she did not attempt ambulation. She also required assistance for her activities of daily living including Min A for bathing and toileting, and Max A for lower body dressing. An individualized therapy plan was developed consisting of physical and occupational therapy. At discharge, she was independent for bed mobility and transfers. She advanced to Mod I to ambulate 1,000 feet with SPC and safely ascend/descend >15 steps. She also regained her independence with self-care including Mod I for bathing and independent for toileting and dressing.
After a successful stay at Logan Square Rehab, the patient returned home with support from family and Bayada Home Health. She will continue to follow with her PCP, Dr. Katherine Sherif in the community.
