Intended for healthcare professionals

Endgames Case Review

A man with a traumatic lower limb injury

BMJ 2019; 367 doi: (Published 28 November 2019) Cite this as: BMJ 2019;367:l6246
  1. James Morris, FY2 orthopaedics,
  2. Usman N Bhatty, ST6 orthopaedics
  1. Royal Preston Hospital, Preston, UK
  1. Correspondence to J Morris jamesm1309{at}

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 …

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