A man with a traumatic lower limb injury

A 59 year old man was driving a motorcycle and collided with a car at 30 miles per hour. He was thrown 30 feet from his bike. Traffic stopped and he was taken to hospital as a major trauma call. On admission he was haemodynamically stable with a Glasgow coma scale of 15. On examination, there was obvious malalignment of his right lower limb, and on the right medial calf was a wound approximately 5 cm long (fig 1). Bruising was noted medially and laterally to the wound. Bone edges were visible through the wound, and it contained debris and dirt from the road. There was no ongoing …