Femoral osteomyelitis with discharging sinus
Prior RTA requiring surgical fixation. Discharge from posterior aspect of the thigh.
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The appearances of the left femur would suggest a prior fracture and ORIF, with the removal of a dynamic hip screw from the femoral neck and upper shaft.
Fluid fills the site of the prior sited dynamic hip screw and extends anteriorly at 1 0'clock caudally for 14cm in the vastus intermedius. No tract to the skin at this site.
A larger tract measuring 1.6cm in diameter derives from the same site, and as it travels caudally it extends posteriorly into the inferior aspect of the gluteus muscle and thereon into the subcutaneous fat ending at a small opening on the posterior aspect of the upper thigh at 5 O'clock.
Fracture of upper femoral shaft which has healed with callus.
Osteomyelitis at the site of prior surgical instrumentation with a sinus and fistulous tract (discharing sinus).