Complications of Fractures

A 32-year-old male presents to the emergency department 6 hours after a motor vehicle accident with a closed fracture of the right femur. On examination, the limb is swollen and tense. Compartment pressure measured at the anterior compartment is 65 mmHg (diastolic blood pressure = 80 mmHg). The patient reports severe pain out of proportion to the clinical findings and pain with passive dorsiflexion of the foot. What is the most appropriate next step in management?

A 28-year-old female sustained a closed fracture of the left tibia and fibula 3 days ago. She was treated with closed reduction and cast immobilization. She now presents with fever (38.5°C), malaise, and localized swelling and warmth over the fracture site. Laboratory investigations show WBC 14,000/μL, ESR 45 mm/hr, and CRP 8.5 mg/dL. Blood cultures are pending. Plain radiographs show early periosteal reaction and cortical lucencies. What is the most likely diagnosis?

Which of the following is the most common early systemic complication of long bone fractures?

Avascular necrosis (AVN) is most likely to occur following fracture of which bone?

A 32-year-old male presents with a closed fracture of the femoral shaft sustained 8 hours ago. On examination, the limb is swollen and tense. You suspect compartment syndrome. Which investigation is most sensitive and specific for confirming compartment syndrome?