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May 21, 1998: Upon arrival to Royal Columbia Hospital, examination of left knee demonstrated two compound wounds. At this time they were not excessively explored due to a significant amount of bleeding noted by EMS.
Summary of intial Investigations: Right knee x-ray showed a transverse fracture of the inferior pole of the patellar that was distracted.
Left knee x-ray revealed a comminuted, bicondylar distal femoral fracture and a comminuted bicondylar tibial plateau fracture.
May 21, 1998: Procedures performed;
a) wound debridement right knee.
b) open reduction and internal fixation of right inferior pole patella fracture. (repair of patella tendon).
c) wound debridement left knee and left leg.
d) open reduction and internal fixation of the left tibial plateau fracture.
e) open reduction and internal fixation of supraintracondylar fracture left distal femur.
f) laceration of the right eyebrow. (six stitches).
(Cleaned opened wounds; repaired fractured right knee and tendon; placed hardware in right knee, left tibia and left femur consisting of two plates and many screws.
May 21, 1998: Suture repair of right patellar tenden avulsion, irrigation and debridement right knee, Irrigation and debridement left knee compound wounds. Open reduction and internial fixation left distal femur (DCS). Open reduction and internal fixation left proximal tibial fracture (condylar buttress plate).
May 24, 1998: Left medial gastrocnemius flap and split thickness sin graph to medial aspect of tibuial plateau.
Resulting complactions: Failure of sufficant soft tissue coverage right tibial plateau compound wound.
Second Procedures: Debridement of muscle flap, left tibial plateau.
May 26, 1998: Hgb has been low 2 units RBC transfused.
May 30, 1998: Transfered to orthopedic ward from acute care.
June 3, 1998: Fitted with drop foot splint for left foot.
June 19, 1998: Admitted to Vancouver General Hospital.
June 21. 1998: Surgical procedure; Debidement of the necrotic gastrocnemius flap and coverage of the resulting defect with a microvascular gracilis muscle flap and skin graph harvested from left thigh. (Skin graph taken from left thigh and used to cover muscle area of lower left leg below the knee and adjacent to the tibia and fibula bones)
(Operation start at 14:40 operation ends at 20:50).
June 23, 1998: Blood transfusion.
July 7, 1998: Surgical procedure; left gracilis skin grafting and diagnosed to have had gram inegative infection in wounds.
July 9, 1998: Two surgical procedures:
1) debridement of left knee.
2) elevation of the muscle flaps back to pedicle with advanement rotation closure with placement of antibiotic beads near orthopaedic hardware.
(Cleaned left knee and placed antibiotic beads near hardware to keep from getting infected) Operation starts at 13:55 operation ends at 15:10).
July 28, 1998: X-rays show a mid thoracic compression fracture at T- 8.
October 14, 1998: Surgical procedure; incision and drainage of infection in left leg and tibia
(because of infection, the left leg, especially in the area of the tibia, was opened and drained. at Royal Columbia Hospital. (Thirteen stitches).
November 24, 1998: Discontinue home IV and continue oral antibiotics.
December 1, 1998: Arrive at Royal Columbia Hospital for pre-administration but told the sugery had been cancelled due to the nurses strike.Doctor confirms that the infection has returned. Stronger antibiotics and an appointment with an infections specialist is given.
January 6, 1999: Two surgical procedures:
1) femur bone graft from left iliac crest is preformed with osteoset bead supplement. antibiotic beads were inserted in the left femur area. Left thigh twenty-seven staples; left hip thirteen staples.
2) Right leg surgery consists of reattaching the patella ctenidium.thirty-five staples. Surgery preformed at Royal Columbia Hospital.
(Repair of tendon on right knee and bone graft from the left hip to the end of the femur area with the insection of antbiotic beads).
January 16, 1999: Discharged from Royal Columbia Hospital, I'm now at home in a hospital bed set up in our living room till April 22, 1999.
February 11, 1999: Red streaks running up left leg, back on antibiotics.
March 26, 1999: Xrays done at Royal Columbia Hospital. Start putting weight through legs as tolerated in swimming pool only.
April 27, 1999: Xrays done at Royal Columbia Hospital. Doctor very concerned about the antibiotic beeds protruding through muscle flap on the left leg. posibility of them tearing through the muscle flap is high and refers me to the plastic surgeon.
July 21, 1999: surgical procedure; reconstruction of exposed left tibial plate with mutiple flaps and split thickness skin graft. Removal of 12 antibiotic beeds that were protruding from left leg. Surgery preformed at University of British Columbia Hospital. Surgery commenced 15:10 Hrs. Surgery completed 16:20 Hrs.
October 12, 2000: Surgical procedure; extensive scar revisions- (left lower extremity) with multiple flap closure.
November 16, 1999: Admited to Royal Columbia Hospital and tested for M.R.S.A. Methicillin-resistant Staphylococcus aureus (MRSA)
November 17, 1999: Surgery procedure; bone grafting from the right iliac crest to the left tibia.
(bone taken from right hip and grafted to site at lower left leg.). Surgery preformed at Royal Columbia Hospital.
November 30, 1999: Doctor inspects OP site and is pleased with the results. Removed twelve staple from right hip and twenty stitches from left shin, at Royal Columbia Hospital.
October 12, 2000: Surgical procedure; Muscle flap reduction and a skin flap revision at two sites on left leg. Surgery preformed at University of British Columbia Hospital.
February 8, 2001: Surgical procedure;Muscle flap revision and skin flap revision at two sites on left leg. Surgery preformed at University of British Columbia Hospital.
February 19, 2001: Forty-six stitches removed.
December 20, 2001: Surgical procedure; removal of hardware from left tibia. some screws remianed. (Hardware removed from left lower leg.) Surgery preformed at Eagleridge Hospital.
Surgical and Hospital Timeline
(ver batim from medical legal reports)
