MEDICAL LEGAL: UTV ROllover Accident.
Medical Legal Illustration • 2022
Open Reduction and Internal Fixation (ORIF) of the Right DISTAL RADIUS Fracture
This piece is part of a series of six mock medical legal visualization exhibits designed to depict a legal case involving a UTV rollover accident. In this incident, a 57-year-old woman was ejected and suffered substantial injuries to her right arm.
The challenge of this project was to create an exhibit of illustrative evidence to clarify complex medical and scientific concepts to a courtroom audience. Maintaining adherence to style guides and meeting client expectations was crucial for creating a cohesive series of medical visualizations. This particular exhibit focuses on illustrating the ORIF of a distal radius fracture sustained during the rollover.
STORY
OVERVIEW
General public, jurors
AUDIENCE
SOFTWARE
Adobe Photoshop, Procreate, Figma
FORMAT
Courtroom presentation, print
CLIENT
Prof. Stephen Mader, University of Toronto
reading radiographic data and medical files, gross anatomy knowledge, science communication to lay audiences, visual storytelling, digital painting, layout
SKILLS
The client is a 57-year-old woman who was a passenger in an UTV rollover accident. She was wearing a helmet, but not seatbelt, and was subsequently ejected from the vehicle.
Case Description
Right hand avulsions and lacerations
Comminuted fracture of the right distal radius
Comminuted fracture of the right olecranon process
INJURIES SUSTAINED
Malunion
Osteoarthritis & osteopenia
Pain
COMPLICATIONS
ORIF of right distal radius fracture
ORIF of olecranon fracture
SURGERY
Right ulna shortening osteotomy
Right extensor carpi ulnaris release
CORRECTIVE SURGERY
Hand laceration
Right olecranon fracture
Right distal radius fracture
Complications
Right ulnar osteotomy
Right extensor carpi ulnaris (ECU) release
Proposed Exhibits
PRODUCTION & REFINEMENT
PROCESS WORK
Prior to gaining access to patient medical records and x-rays, I began by planning out the content and layout of my designated exhibit. This exhibit will focus on the fracture to the distal radius of the patient’s right wrist caused by the accident. The orientation image demonstrates the position of the arm with respect to the viewer. Radiographs and an illustration of the injury are depicted on the left, followed by a larger post-op illustration of the open reduction internal fixation (ORIF) surgery along with radiographs.
Initial Planning
Comminuted osteochondral intra-articular fracture of the distal radius. Multiple radiopaque fragments in the soft tissues.
DETAILS OF INJURY
ORIF of a comminuted intra-articular fracture of the distal radius with a volar plate, multiple screws (4 distal, 3 proximal). The ORIF was followed by a bone graft because the screws were catching the osteochondral fracture.
DETAILS OF SURGERY
After getting feedback and approval of the initial sketch, I began to refine it as I compiled references and notes from the patient’s medical records and my own research. I corrected the orientation image and the angle of the wrist based on the x-rays provided and further refined the layout.
Refinement
Since it was important to illustrate the significance of the metal plate attached to the radius post-op and its effect on the patient’s quality of life and potential complications, I decided to change the point of view of the exhibit and instead show the palmar view of the wrist rather than dorsal. Based on feedback from peers and Prof. Stephen Mader, this was an effective change and its intended effect was successful.
Final Exhibit
In reality, anatomical structures that are viewed mid-surgery are red because of the abundance of blood. For a didactic illustration, the following was considered:
Colors were chosen so that different anatomical structures can be easily identified by color (adipose in comparison to bone).
Anatomical conventions of color were followed so viewers can apply their knowledge of anatomy that they have seen elsewhere (i.e: adipose tissue is an exaggerated yellow color).
As opposed to a purely didactic illustration, less saturated colors were used to better reflect the serious tone of the patient's medical trauma