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Dr. Andrew Rynne

Family Physician

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We had an unfortunate situation in Cancun, Mexico with my

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Dr. Vasudha Jayant Athavale

General & Family Physician

Practicing since :1970

Answered : 6903 Questions

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Posted on Wed, 9 Jan 2019 in Bones, Muscles and Joints
Question: We had an unfortunate situation in Cancun, Mexico with my friend. We've admitted him to Grupo Playa Med. The doctors seem somewhat competent but not very communicative. Of course, money is their primary concern which we have given.

He broke both of his legs. We're originally from XXXXXXX Canada.

This the letter they have given us, I translated using Google translate:

Beach & Med. C Hospilal ORTHOPEDICS AND TRAUMATOLOGY EMERGENCY EVALUATION Patient: BHAZIT XXXXXXX Age: 20 ancs Date: 1412/18 Time: 18:30 Male patient of 20 years who suffered an accident of ransio approximately 3 hours ago. He is received in this unit transferred by ambulance. He refers intense pain in right thigh and left foot. The scan shows a defotmity in the left leg with intense pain and angular deformity at the level of the middle third. Palpation is palpated and a wound of 1 cm is observed, which bleeds with fat micelles. In the right irferier limb there is deformity in the thigh with external rotation of the limb and shortening of the intensity of the mobilization and palpation of the area. The pulses are present and symmetrical in both lower limbs. From the general view point, the patient looks pale, thirst and radial pulse of 98 X. It is interpreted as compensation for the loss of blood pressure čc both fractures Laboratory tests urro an Hb of 14.3 mg / L. for which it is considered to work with plasma expanders and follow-up of evolutionary hematologic biometrics in the wrist. Right femur radiograph: Subtrochanteric fracture with the left tibia. Transverse tissue of the middle third of the warm ciaiysis, with an integral fibula. A patient was screened in the emergency room for a wash of the leg wound and covered with gauze rilcs. Traction was placed by blunt parts on the right extremity and plaster cast on the left extremielac. Sc solicia blood to gaarde and cross. Diagnosis: Subtrochanteric fracture of the right femur. Fracture exposed grade I of Gustilo in left thia. Prognosis: Reserves due to risk of infection, rhomboembolism, hypovolemic shock, psuchoarthrosis, osteomyelitis, difficulty walking. patient Requires surgical lavage and asteosinteis of the left tibia to the short the fixation is requestedGlavo center megular bloqedd titanium or external breech requires a wide hloqueada plate of temur of 12 to 14 perforations José XXXXXXX Çamacho Frías Orthopedic CP: 0000 CE T0 r .: natology 0000


They haven't done surgery for 3 days now and are putting it off even further as his haemoglobin is low. I don't know if we should take him to a better doctor or what we should do. We can't fly him out as they say it's dangerous due to possible blood clots (he's on blood thinners)

Any pointers would be appreciated. Also, we did not get Medical insurance so all would be paid out of pocket. At this point, money is no object. We have already paid 90,000 pesos for them to start the procedure and are looking to pay 130-150,000 according to their estimate.

Should we move him to a different hospital? Is this normal? Is this procedure safe? We're all very confused what to do.
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Follow up: Dr. Vasudha Jayant Athavale 0 minute later
They've also said he may lose some of his height.

Also what is the recovery time were looking at? How fast can we get him back to Canada?
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Answered by Dr. Vasudha Jayant Athavale 5 hours later
Brief Answer:
It is risky to shift him... let him be treated where he is.

Detailed Answer:
Hi Shehmeerahmad,
Thanks for asking. I have read to gather most of the information from the translated report you have posted... &understand your concern.
Your friend does have serious injuries in both of his legs...which can be repaired well in hands of expert team of doctors(which you seem to have selected)... the point of concern is his severe bleeding which had made him increasingly weak & made it difficult to go with the management of the wounds immediately. They are at the moment taking care of his blood loss ,preventing complications of the incidence like thromboembolism ,infection .
*Rest of the complications they are referring to (like shortening of leg,osteoarthritis ) are late aftermaths of the of injuries &need to be managed after both legs are treated &heal well....
I feel they would take active actions for surgery once his general condition is settled & is strong enough to stand the procedures....From the name of the institute &report they give it seems they are capable of handling the situation ..
* Shifting him seems risky for him till hi general condition improves....you can definitely take on line second opinion of experts at his home town, &get convinced about the line of management being followed./ you can take second advise of orthopedic surgeon in the same town you are in... by showing him copies of reports a ailable.
** Though money does not seem to be a problem for you ,his safty should be your primary concern .... so don't try to shift him in haste &let him be treated by the experts in the hospital he is already admitted to ( they seem to be confident enough to handle the situation). as shifting itself can expose him to thromboembolism.You can definitely discuss amicably with the treating doctors &get convinced ... that is your right.
** He can be taken to his home town with due care after minimum 2-3 months of his successful surgery ...& what matters now is his stabilised health fit for operations (normal pulse,blood pressure/a sence of infection &covered risk of thromboembolism.) so that surgery can be done.
I hope that satisfies you. Any follow up query is welcome.
Thanks.
Above answer was peer-reviewed by : Dr. Remy Koshy
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