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 the wound, and it contained debris and dirt from the road. There was no ongoing …

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