Musculoskeletal case studies for medical students

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History A 20 year old male gangster was shot in the lower limb. Neurovascular intact, no other injuries
Initial X ray
Description AP X ray
X ray
Description Lateral x ray
Problem The 20 year old gangster who was shot in the lower limb. How this was treated, and why.
X ray after treatment
Description After treatment by intramedullary rod
Post management further view
Classification There is a fracture of the proximal third of the femur shaft. The fracture area is comminuted and fragments of the projectile can be seen about the fracture.
Discussion of management This is an open fracture and needs debridement. The bullet tract was debrided. There is no need to remove the bullet or its fragments, as this is deep within muscle. If the bullet was in a joint it would require removal.


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