CHIEF COMPLAINT: s/p MVA

PRESENT ILLNESS: Mr. [**Known firstname **] [**Known lastname **] is a 29-year-old gentleman who was involved in a
motor vehicle accident. He was a passenger in the back seat,
resulting in a motor vehicle collision. He sustained the
isolated injury to his acetabulum as described. The patient was
initially managed with traction while temporizing him for
surgery and stabilizing him from this standpoint. He is now
ready for surgery and proceeding to the operating room for
repair of his acetabular fracture. The plan is to perform
modified extensive approach as described by [**Last Name (un) 63262**] and [**Last Name (un) 19499**].
In order to address both the significant posterior wall
comminution, posterior wall and anterior column and posterior
column transverse nature of the fracture, the posterior wall has
a very high piece involving the weightbearing bone which I think
will not be possible to reduce via a posterior approach.

MEDICAL HISTORY: None

MEDICATION ON ADMISSION: 

ALLERGIES: Penicillins

PHYSICAL EXAM: 

FAMILY HISTORY: NC

SOCIAL HISTORY: NC
Closed fracture of acetabulum,Closed fracture of malar and maxillary bones,Closed fracture of base of skull without mention of intra cranial injury, with no loss of consciousness,Closed fracture of metacarpal bone(s), site unspecified,Other motor vehicle traffic accident involving collision with motor vehicle injuring passenger in motor vehicle other than motorcycle
Fracture acetabulum-clos,Fx malar/maxillary-close,Cl skul base fx w/o coma,Fx metacarpal NOS-closed,Mv collision NOS-pasngr
Admission Date:  [**2109-10-12**]              Discharge Date:   [**2109-10-23**]

Date of Birth:  [**2080-6-28**]             Sex:   M

Service: ORTHOPAEDICS

Allergies:
Penicillins

Attending:[**First Name3 (LF) 11415**]
Chief Complaint:
s/p MVA

Major Surgical or Invasive Procedure:
Open reduction internal fixation of right transverse posterior
wall, comminuted acetabular fracture via extended iliofemoral
approach.


History of Present Illness:
Mr. [**Known firstname **] [**Known lastname **] is a 29-year-old gentleman who was involved in a
motor vehicle accident. He was a passenger in the back seat,
resulting in a motor vehicle collision. He sustained the
isolated injury to his acetabulum as described. The patient was
initially managed with traction while temporizing him for
surgery and stabilizing him from this standpoint. He is now
ready for surgery and proceeding to the operating room for
repair of his acetabular fracture. The plan is to perform
modified extensive approach as described by [**Last Name (un) 63262**] and [**Last Name (un) 19499**].
In order to address both the significant posterior wall
comminution, posterior wall and anterior column and posterior
column transverse nature of the fracture, the posterior wall has
a very high piece involving the weightbearing bone which I think
will not be possible to reduce via a posterior approach.


Past Medical History:
None

Social History:
NC

Family History:
NC

Pertinent Results:
[**2109-10-12**] 08:59PM   POTASSIUM-4.0
[**2109-10-12**] 08:59PM   MAGNESIUM-2.3
[**2109-10-12**] 08:59PM   HCT-35.2*
[**2109-10-12**] 02:50PM   TYPE-ART PO2-236* PCO2-44 PH-7.42 TOTAL
CO2-30 BASE XS-4
[**2109-10-12**] 02:50PM   freeCa-1.10*
[**2109-10-12**] 07:50AM URINE  bnzodzpn-POS barbitrt-NEG opiates-POS
cocaine-NEG amphetmn-NEG mthdone-NEG

Brief Hospital Course:
Patient was admitted to trauma surgery and underwent the above
procedure. The procedure was complex, more extensive than
anticipated and took 6 full hours. The patient tolerated the
procedure well however, and was taken to the recovery room in
stable condition. He spent the night in the PACU and anesthesia
felt it was best to wait on extubation until his face was less
swollen due to a rather difficult intubation. He was extubated
on POD1 without incident. His post-operative course was
significant for a drop in hematocrit for which he received
several units of blood and then stabilized. He also has elevated
CK on admission which along with LFTs and renal function was
followed closely. He never went into ARF and BUN/cr were always
stable. CK trended down. Patient began to work with PT on POD1.
The other main issue was his facial fractures, for which plastic
surgery did not feel surgery was indicated. He needs to continue
a soft diet until he follows-up with plastic surgery. About a
week into his admission he developed increased L eye swelling
and double vision. Opthamology was consulted and felt there was
no entrapement of the extra-ocular muscles. Plastics recommended
a repeat CT which was obtained and showed no change in the
status of the non-operative facial fractures. He is being
dicharged to rehab in stable condition. His hematocrit has been
stable in the 30ish range for the past week and his pain has
been better controlled. His main issue now is really
rehabilitation.

Discharge Medications:
1. Insulin Regular Human 100 unit/mL Solution Sig: as directed
Injection ASDIR (AS DIRECTED): per rehab protocol.
2. Polyvinyl Alcohol 1.4 % Drops Sig: 1-2 Drops Ophthalmic  QID
(4 times a day) as needed for comfort.
3. Enoxaparin 40 mg/0.4mL Syringe Sig: One (1)  Subcutaneous
DAILY (Daily) for 4 weeks.
4. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2)
Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed.
5. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
6. Magnesium Hydroxide 400 mg/5 mL Suspension Sig: Thirty (30)
ML PO Q6H (every 6 hours) as needed.
7. Acetaminophen 500 mg Tablet Sig: Two (2) Tablet PO Q 8H
(Every 8 Hours).
8. Oxycodone 5 mg Tablet Sig: Three (3) Tablet PO Q4-6H (every 4
to 6 hours) as needed for pain.
9. Famotidine 20 mg Tablet Sig: One (1) Tablet PO Q12H (every 12
hours).
10. Lorazepam 0.5 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4
to 6 hours) as needed.
Disp:*60 Tablet(s)* Refills:*0*


Discharge Disposition:
Extended Care

Facility:
[**Hospital3 7665**]

Discharge Diagnosis:
Right transverse posterior wall acetabular fracture.


Discharge Condition:
Stable


Discharge Instructions:
Please keep your incision clean and dry. You may shower but
don't tub bathe for 2 weeks. Watch for signs and symptoms of
infections as per the nursing discharge information.
You need to follow-up with Dr. [**Last Name (STitle) 1005**] in 2 weeks. Your
staples can be taken out at rehab 10-14 days after surgery
(surgery on [**10-14**]).
Physical Therapy:
Activity:  Ambulate
 Pneumatic boots
 Right lower extremity:  Non weight bearing
STRICT POSTERIOR HIP DISLOCATION PRECAUTIONS<br>NO ACTIVE
ABDUCTION<br>ABDUCTION BRACE UNTIL AWAKE AND FOLLOWING
INSTRUCTIONS

Treatments Frequency:
R thigh dressing changes daily as needed.

Followup Instructions:
Please follow-up in 2 weeks with Dr. [**Last Name (STitle) 1005**]. Please call his
office ([**Telephone/Fax (1) 2007**] ahead of time to make an appointment.


                             [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 2235**] MD, [**MD Number(3) 11417**]

Completed by:[**2109-10-23**]
{'Closed fracture of acetabulum,Closed fracture of malar and maxillary bones,Closed fracture of base of skull without mention of intra cranial injury, with no loss of consciousness,Closed fracture of metacarpal bone(s), site unspecified,Other motor vehicle traffic accident involving collision with motor vehicle injuring passenger in motor vehicle other than motorcycle'}


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: s/p MVA

PRESENT ILLNESS: Mr. [**Known firstname **] [**Known lastname **] is a 29-year-old gentleman who was involved in a
motor vehicle accident. He was a passenger in the back seat,
resulting in a motor vehicle collision. He sustained the
isolated injury to his acetabulum as described. The patient was
initially managed with traction while temporizing him for
surgery and stabilizing him from this standpoint. He is now
ready for surgery and proceeding to the operating room for
repair of his acetabular fracture. The plan is to perform
modified extensive approach as described by [**Last Name (un) 63262**] and [**Last Name (un) 19499**].
In order to address both the significant posterior wall
comminution, posterior wall and anterior column and posterior
column transverse nature of the fracture, the posterior wall has
a very high piece involving the weightbearing bone which I think
will not be possible to reduce via a posterior approach.

MEDICAL HISTORY: None

MEDICATION ON ADMISSION: 

ALLERGIES: Penicillins

PHYSICAL EXAM: 

FAMILY HISTORY: NC

SOCIAL HISTORY: NC 

### Response:
{'Closed fracture of acetabulum,Closed fracture of malar and maxillary bones,Closed fracture of base of skull without mention of intra cranial injury, with no loss of consciousness,Closed fracture of metacarpal bone(s), site unspecified,Other motor vehicle traffic accident involving collision with motor vehicle injuring passenger in motor vehicle other than motorcycle'}
