Muhamad Na'im B Ab Razak (jacknaim) is a fresh graduate Muslim Doctor from Universiti Sains Malaysia and waiting for the enrollment into the housemanship program. Ambitious in pursuing master program in emergency and traumatology medicine and loves to spent his free time joining humanitarian missions, writing and speaks as an amateur public speaker in motivation and comparative religion. [HOME]

20 years old man with tender and swelling of the right lower limb

Answer

1) Plain radiography
- This is an AP film of the right Tibia-Fibula
- Segmental fracture of the upper tibia
- Fibular bone is not fractured
- Ankle joint and knee joint is not disrupted.


2) Mechanism of injury
- Direct trauma
- Twisting injury
** Notes: tibia fracture alone may also be caused by fatigue fracture that occurs at junction of middle and upper third. Unlikely in this case.


3) Complications includes soft tissue damage, vascular damage, skin loss, compartment syndrome, mal union, non union


4) Intramedullary nail because
- Segmental fracture is unstable
- There is a cut of nutrient artery. Putting a plate will further compromise the periosteal artery, hence impair the bone healing.