A 51-year-old man is transferred to your facility following a high-speed motor vehicle collision. Details of the accident are unclear, but there was a prolonged extrication time. It is reported that the patient was complaining of severe left lower extremity pain prior to being intubated for hemodynamic instability and for airway protection.
Physical examination shows an intubated, sedated man with a blood pressure of 90/60 mm Hg and a heart rate of 140 beats/min. Examination of the left leg demonstrates no obvious deformity, although moderate swelling is noted over the knee and tibia. Sensation appears grossly intact. Good capillary refill is noted in the toenails.
Radiograph of the left tibia/fibula is shown.
Answer
The radiograph demonstrates no acute fracture within the tibia or fibula. There is an osseous deformity noted within the distal fibula; however, this is most likely consistent with a previous healed fracture. The source of this patient’s pain was a fractured distal femur.
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