CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient presented in the
evening of [**2122-2-24**] status post MVA.  The patient is a 52 year
old male status post MVA.  At 8:00 a.m. the patient was the
restrained driver involved in a head-on collision.  No loss
of consciousness, no air bag.  Approximate combined speed of
50 miles per hour.  The patient was taken to an outside
hospital.  Noted injuries were significant for rib fracture
times two, right patella fracture, right talus fracture, left
tibial plateau fracture, multiple left shoulder contusions.
No other findings per report.  CT scans were done at the
outside hospital, no films were sent with the patient.

MEDICAL HISTORY: ETOH abuse.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Closed fracture of patella,Acute alcoholic intoxication in alcoholism, continuous,Alcohol withdrawal,Cellulitis and abscess of leg, except foot,Closed fracture of unspecified part of fibula with tibia,Other motor vehicle traffic accident involving collision with motor vehicle injuring driver of motor vehicle other than motorcycle,Street and highway accidents
Fracture patella-closed,Ac alcohol intox-contin,Alcohol withdrawal,Cellulitis of leg,Fx tibia w fibula NOS-cl,Mv collision NOS-driver,Accid on street/highway
Admission Date:  [**2122-2-24**]       Discharge Date:  [**2122-3-10**]

Date of Birth:   [**2069-10-25**]       Sex:  M

Service:  ORTHO

PAST MEDICAL HISTORY:  ETOH abuse.

ALLERGIES:  No known drug allergies.

MEDICATIONS:  Ativan, Lopressor, Zantac, Actol.

PAST SURGICAL HISTORY:  Umbilical herniorrhaphy.  Left knee
arthroscopy.

HISTORY OF PRESENT ILLNESS:  The patient presented in the
evening of [**2122-2-24**] status post MVA.  The patient is a 52 year
old male status post MVA.  At 8:00 a.m. the patient was the
restrained driver involved in a head-on collision.  No loss
of consciousness, no air bag.  Approximate combined speed of
50 miles per hour.  The patient was taken to an outside
hospital.  Noted injuries were significant for rib fracture
times two, right patella fracture, right talus fracture, left
tibial plateau fracture, multiple left shoulder contusions.
No other findings per report.  CT scans were done at the
outside hospital, no films were sent with the patient.

PHYSICAL EXAMINATION:  The patient was A&O times three,
following commands, afebrile, vital signs stable.  Neck
supple, full range of motion, no tenderness to palpation.  CV
regular rate and rhythm.  Lungs clear to auscultation.  Right
upper extremity negative tenderness to palpation, full range
of motion, neurovascularly intact.  Left upper extremity
positive proximal humerus contusion, ecchymosis, skin intact,
positive tenderness to palpation, negative crepitus.  Left
thumb radial volar laceration.  Right lower extremity
positive distal thigh tenderness to palpation with moderate
ecchymosis, positive right patella tenderness to palpation,
large right knee effusion, positive proximal lateral medial
tibial tenderness to palpation and tenderness to palpation
along the tibial spine.  Positive right ankle swelling,
positive tenderness to palpation in hindfoot.  Sensation
intact in TP, SPT.  Sensation intact to light touch.
Palpable PT and DP pulse.  Left lower extremity positive
distal thigh tenderness to palpation, moderate left knee
effusion, moderate left proximal leg swelling with fracture
blisters medially and anteriorly.  Skin intact.  Calf firm,
negative tenderness to palpation.  Distal left leg
laceration.  [**Name (NI) **] DP, PT pulse.  Sensation intact in
TP, SPT.  Sensation intact to light touch.  No increased pain
with passive range of motion left ankle and toes.

IMAGING STUDIES:  Repeat x-rays taken at that time showed
right patella fracture, left comminuted tibial plateau
fracture, right talus fracture, several rib fractures.

HOSPITAL COURSE:  The patient was made NPO, IV fluids.
Repeat x-rays.  Discussed with Dr. [**Last Name (STitle) 284**] who would plan
for operative repair.  The patient was made nonweight bearing
bilateral lower extremities with knee immobilizers.  Awaiting
clearance from the medical team for OR for IF right patella
fracture.  On [**2122-3-2**] the patient was taken to the OR for
ORIF left tibial plateau fracture, ORIF right patella
fracture.  Surgery went without incident.  On post-op check
the patient was feeling better.  Pain managed on fentanyl
PCA.  CPM on the left lower extremity.  Right lower extremity
with [**Doctor Last Name **] brace.  The patient was A&O times three.  Good
distal pulses.  Warm extremities.

On post-op day two the PCA was discontinued.  Right lower
extremity with short leg cast.  [**Doctor Last Name **] brace intact.
Sensation intact to DP.  Moves toes.  Cap refill less than
two seconds.  Left lower extremity with [**Doctor Last Name **] brace in
place.  Sensation intact to TP, SPT.  Motor [**5-11**] at [**Last Name (un) 938**], FHL,
DP 1+.  In summary, this was a 52 year old male status post
ORIF left tibial plateau fracture, cerclage right patella
fracture.  Activity nonweight bearing bilateral lower
extremities.  Right lower extremity [**Doctor Last Name **] locked in full
extension.  Left lower extremity [**Doctor Last Name **] unlocked.  Lovenox
40 mg subcu q.d. for four weeks for anticoagulation.
Continue Levaquin for pneumonia.  Discharge to home when
cleared by physical therapy.

The patient was discharged on [**2122-3-10**] to home.  Left lower
extremity nonweight bearing with [**Doctor Last Name **] brace unlocked.
Right lower extremity weight bearing as tolerated with
[**Doctor Last Name **] locked in extension.  Lovenox 40 mg subcu q.d. times
four weeks for anticoagulation.

DISCHARGE DIAGNOSES:
1.  Left tibial plateau fracture status post ORIF on [**2122-3-2**].
2.  Right patella fracture status post ORIF.

FOLLOWUP:  Follow up with Dr. [**Last Name (STitle) 284**] in one week in
trauma clinic, phone number [**Telephone/Fax (1) 5499**].

CONDITION ON DISCHARGE:  Good.

DISCHARGE MEDICATIONS:
1.  Lovenox 40 mg subcu q.d. for a four week course.
2.  Percocet #5 one to two tabs p.o. q.four to six hours
p.r.n.





                            [**Name6 (MD) **] [**Name8 (MD) 13714**], M.D.  [**MD Number(1) 13715**]

Dictated By:[**Last Name (NamePattern1) 20276**]
MEDQUIST36

D:  [**2122-6-15**]  10:42
T:  [**2122-6-15**]  10:45
JOB#:  [**Job Number 52826**]
{'Closed fracture of patella,Acute alcoholic intoxication in alcoholism, continuous,Alcohol withdrawal,Cellulitis and abscess of leg, except foot,Closed fracture of unspecified part of fibula with tibia,Other motor vehicle traffic accident involving collision with motor vehicle injuring driver of motor vehicle other than motorcycle,Street and highway accidents'}


You are an AI assistant analyzing clinical admission notes from the MIMIC III dataset. Your task is to map symptoms mentioned in the notes to a list of provided ICD-9 LONG_TEXT.



### Clinical text :
CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient presented in the
evening of [**2122-2-24**] status post MVA.  The patient is a 52 year
old male status post MVA.  At 8:00 a.m. the patient was the
restrained driver involved in a head-on collision.  No loss
of consciousness, no air bag.  Approximate combined speed of
50 miles per hour.  The patient was taken to an outside
hospital.  Noted injuries were significant for rib fracture
times two, right patella fracture, right talus fracture, left
tibial plateau fracture, multiple left shoulder contusions.
No other findings per report.  CT scans were done at the
outside hospital, no films were sent with the patient.

MEDICAL HISTORY: ETOH abuse.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Closed fracture of patella,Acute alcoholic intoxication in alcoholism, continuous,Alcohol withdrawal,Cellulitis and abscess of leg, except foot,Closed fracture of unspecified part of fibula with tibia,Other motor vehicle traffic accident involving collision with motor vehicle injuring driver of motor vehicle other than motorcycle,Street and highway accidents'}
