Medical Report: Patricia Bertier Introduction Patricia Bertier is a 32-year-old female who presented to our clinic with several medical conditions exacerbated by a recent accident. After thorough evaluation and consideration, she underwent a surgical operation and is now undergoing a long-term treatment course with orthopedic KAFO leg braces. This medical report aims to provide a detailed overview of Patricia's medical history, ongoing treatment, and prognosis. Medical History Patricia's medical history is notable for several conditions that have been diagnosed and managed over the years. She has a history of polycystic ovary syndrome, obesity, and gastroesophageal reflux disease (GERD). She has been treated for these conditions with hormonal therapy, dietary modifications, and proton pump inhibitors, respectively. Patricia also has a significant history of lower extremity conditions. She has been diagnosed with bilateral knee osteoarthritis and patellofemoral syndrome. She has undergone various conservative treatments, including physical therapy and knee injections, without significant improvement. Additionally, she has a history of deep vein thrombosis (DVT) in her left leg, which was treated with anticoagulation therapy. Recent Accident In March of 2021, Patricia was involved in a motor vehicle accident that exacerbated her pre-existing lower extremity conditions. She sustained bilateral fractures of her tibial plateau, which required surgical intervention. She underwent an open reduction and internal fixation of both knees with placement of hardware. Course of Treatment After the surgical intervention, Patricia was placed in knee immobilizers for several weeks to facilitate healing. Once the immobilizers were removed, she began experiencing significant pain and instability in both knees, limiting her mobility and ability to perform daily activities. After thorough evaluation and discussion with Patricia, we recommended a course of treatment that included the use of orthopedic KAFO leg braces. These braces, which extend from the thigh to the foot, were custom-fitted to her legs and locked in the extended position at a 60-degree angle using a spreader bar. The goal of the braces was to provide support and stability to the knee joint, limit range of motion, and promote healing. Patricia was instructed to wear the braces for 23 hours per day, removing them only for showering and skin checks. Considerations for Treatment Preference The decision to use KAFO leg braces as a long-term treatment option for Patricia was based on several factors. Firstly, her pre-existing lower extremity conditions and recent bilateral knee fractures made her susceptible to further injury and instability if left untreated. The KAFO braces provide additional support and stability to the weakened joint, limiting the risk of further injury. Furthermore, traditional treatment options such as physical therapy and knee injections had failed to provide significant relief to her symptoms. Conservative measures had reached their maximum benefit and the braces represented a viable option for further treatment. Finally, the goal of the braces was to promote healing and improve Patricia's overall quality of life. By increasing stability and reducing pain and discomfort, she was able to perform daily activities to a greater extent and ultimately improve her overall prognosis. Long-Term Immobilization The decision to immobilize Patricia's legs in a fixed position for long-term was not made lightly. However, given the significant pre-existing conditions and recent accident, we deemed it necessary to promote healing and limit the risk of further injury. The KAFO braces were locked in a 60-degree angle position to provide maximum stability and support to the knee joint. The spreader bar connecting the two braces also helps to ensure symmetry and reduces strain on the joints. We do not anticipate any long-term adverse effects from the immobilization and believe the benefits outweigh the risks. Adaptation to Social and Professional Life Wearing KAFO leg braces for 23 hours per day can be challenging for any individual. We recognize that this treatment course presents significant challenges to Patricia's social and professional life. However, we encourage her to maintain a positive mindset and to focus on the long-term benefits of the treatment course. We also have referred her to a physical therapist to help her adapt to her new lifestyle and to assist in exercises that are safe to perform while wearing the braces. Additionally, Patricia has been instructed to perform regular skin checks and to care for her skin to ensure that no skin breakdown or infections develop. Prognosis Patricia's prognosis depends on multiple factors, including compliance with the treatment course and the severity of her pre-existing conditions. We anticipate full healing of her bilateral knee fractures and significant improvement in her pre-existing lower extremity conditions. She has shown good compliance with the treatment course so far and we expect continued compliance. Conclusion In summary, Patricia Bertier is a young active woman with a significant medical history and recent motor vehicle accident. After thorough evaluation, she was placed on a long-term treatment course involving KAFO leg braces. Although this treatment course poses social and professional challenges, it provides additional stability to her lower extremity joint and promotes healing. We encourage continued compliance with the treatment course and anticipate a positive prognosis.