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A complication after internal fixation of fracture
  1. W J Sotheran,
  2. P M Perry
  1. Department of Surgery, Queen Alexandra Hospital, Southwick Hill Road, Cosham, Portsmouth, PO6 3LY, UK
  1. Dr Sotheran

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Answers on p 214.

A 66 year old man was referred to the vascular surgery department from the orthopaedic unit. The patient had developed an abnormal, bleeding swelling over the lateral aspect of the left leg. Twelve days earlier he had had an open reduction and internal fixation of a comminuted fracture of his tibia and fibula. The injury was sustained seven months earlier. Previous surgery to the injury had resulted in non-union of fracture. At operation, a thigh tourniquet was employed. Corticocancellous bone grafts were taken from the posterior iliac crests. A rigid eight hole plate was applied across the fracture site. An interfragmentary screw was used. The wound was bleeding in the recovery room but no further surgical intervention was required.

Diagnostic imaging was requested. The radiological findings are shown in fig1.

Figure 1

Radiological findings.

Questions

(1)
What is the investigation and what does it show?
(2)
What clinical symptoms may be associated with this type of lesion?
(3)
How should this lesion be managed and what are the complications?

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