Complications of Fractures

A 32-year-old man sustains a comminuted fracture of the femur in a motor vehicle accident. Regarding the early and late complications of long bone fractures, all of the following are recognized complications EXCEPT:

A 32-year-old male presents to the emergency department 8 hours after a crush injury to the right leg from a fallen concrete slab. He has severe pain, swelling, and tense compartments on clinical examination. Serum creatinine is 1.8 mg/dL (baseline 0.9), potassium 6.2 mEq/L, and urine dipstick shows 3+ blood but RBC count is 0–2/hpf. What is the most appropriate immediate next step in management?

A 35-year-old woman is admitted with a comminuted fracture of the right tibia and fibula sustained 8 hours ago. She is hemodynamically stable. On day 2, she develops fever (38.5°C), tachycardia (110 bpm), and purulent drainage from the fracture site. Gram stain shows gram-positive cocci in clusters. What is the most appropriate next step in management?

Which clinical feature best distinguishes fat embolism syndrome from acute respiratory distress syndrome (ARDS) in a patient with multiple long bone fractures?

A 32-year-old man sustains a crush injury to his right leg in a motor vehicle accident. He develops acute kidney injury 6 hours after injury. Which is the most common cause of acute kidney injury in crush syndrome?