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Orthopedic Surgery - Orthopedic Trauma
A 19-year-old male was admitted following a motorbike accident with multiple injuries, including a diaphyseal fracture of the left femur and ipsilateral tibia (floating knee), a right acromioclavicular (AC) joint type II injury, and a minimally displaced right distal radius fracture. He was scheduled for emergent orthopaedic surgery, which involved retrograde intramedullary nailing of the left femur and antegrade nailing of the left tibia. The procedure was conducted under general anaesthesia, with the patient placed in the lithotomy position for a total of 4 hours and 20 minutes. His right intact leg was kept in 100° of hip flexion and 90° of knee flexion throughout the operation. Upon regaining consciousness, the patient reported severe pain in the right (uninjured) calf, which progressively worsened over the next three hours, remaining unresponsive to analgesics. On examination, there was marked swelling of the right calf, pain on passive movement of the toes and ankle, and progressive weakness in the anterior tibialis and extensor hallucis longus muscles.
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