A traumatic knee injury

A woman in her 60s presented to the emergency department two hours after a road traffic incident which had resulted in a high impact injury to her right leg. She reported dull, persistent pain and an inability to move her leg. Upon examination, the patient’s vital signs were stable. Two superficial lacerations were visible on the outer side of the lower leg, accompanied by minor bleeding and slight swelling. She had tenderness in the knee joint, limited knee movement, slightly weakened dorsalis pedis pulse, and numbness in the foot. Her body temperature was normal and sensation in other areas was normal. She reported a history of diabetes and cerebral infarction. Radiographs of the lower limb were taken upon initial examination which showed a tibial plateau fracture (fig 1).