Femoral fracture

Case contributed by Mr Andrew Murphy

Presentation

High speed car crash.

Patient Data

Age: 18 years
Gender: Male
X-ray

There is a heavily comminuted fracture of the right femur, mid shaft. Significant posterior displacement can be seen on the lateral views.

CT

Heavily comminuted fractrure of the mid diaphysis of the femur, with posterior displacement, there is a a sudden cutoff at the profunda femoris at the mid femur yet the SFA and the popliteal artery are normal. Subcutaneous air gives evidence of an open injury. Anterior compartment demonstrates an intramuscular haematoma.

The left medial patella is comminuted, with a significant soft tissue defect, the anterior portion of the medial aspect of the femoral condyle is also heavily communited.

Case Discussion

The presence of subcutaneous air raises high suspicion of an open or compound fracture. These fractures have a high rate of microbial contamination 1; this patient went immediately to operating theatre for surgical decontamination and external fixation.

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Case information

rID: 48399
Case created: 5th Oct 2016
Last edited: 19th Apr 2017
Inclusion in quiz mode: Included

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