Highly comminuted fracture - gun shot injury

Case contributed by Dr Matt Skalski

Presentation

Gun shot wounds.

Patient Data

Age: 20
Gender: Male

There are markedly comminuted fractures of the proximal tibia and fibula, involving the mid to proximal third of the diaphyses, with scattered metallic bullet shrapnel throughout the fracture site which extends into posterior soft tissues along the bullet wound course. The osseous fragments are scattered and moderately disorganized in their arrangement, and moderately displaced from their parent sites. The distal leg is mildlly laterally angulated and medially rotated relative to proximal. 

Case Discussion

Typical example of a severely comminuted fracture, which when mid-diaphyseal is often sequela of direct trauma, such as from a crush injury or gun shot wound. Similar fracture patterns can be seen more commonly in the metaphyses, which typically occur secondary to an acute axial load. 

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