title: Proximal tibia and fibula fragility fracture complicated by anticoagulation and demand-mediated myocardial infarction.
abstract: We present for discussion a case of a right displaced proximal metaphyseal tibial fracture with intraarticular extension and a same-level proximal fibula fracture with severe degenerative arthritis in a medically complex 89 year old community dwelling woman with a history of paroxysmal atrial fibrillation, right lower extremity deep venous thrombosis 1 month prior to this admission on warfarin, obesity, peripheral vascular disease, and previous stroke. Her course is complicated by demand-mediated myocardial infarction. This case demonstrates that comanagement can lead to minimal delays and a satisfactory outcome in a complex, high-risk patient.
authors.affiliation: Department of Medicine, Highland Hospital; Division of Geriatrics, University of Rochester School of Medicine & Dentistry, Rochester, NY.
authors.forename: Daniel
authors.initials: D
authors.lastname: Mendelson
authors.forename: Stephen
authors.initials: S
authors.lastname: Kates
authors.forename: Jason
authors.initials: J
authors.lastname: Pacos
authors.forename: Nathan
authors.initials: N
authors.lastname: Clark
authors.forename: Joanne
authors.initials: J
authors.lastname: Wu
keywords: comanagement; demand-mediated myocardial infarction; fragility fracture; warfarin reversal