Dr. Kirby von Kessler: A few minutes after being struck by an automobile, a 61-year-old pedestrian was admitted to the emergency ward of the Massachusetts General Hospital. No pulse rate or blood pressure could be obtained. After he received 3 units of whole blood and 2 units of plasma his vital signs stabilized. He complained of abdominal pain. Although the physical examination showed some tenderness in the left upper quadrant of the abdomen, his bowel sounds were active. An indwelling Foley catheter, placed into the bladder, drained clear urine. He did not complain of thoracic discomfort, and his respirations were normal.
The patient had multiple abrasions over his lower extremities with a deep, contaminated laceration over the proximal anterolateral part of the right thigh. There was swelling and abnormal motion of both the right and left thighs. Sensation and motor power were normal in his lower extremities. The distal pulses
Aufranc OE, Jones WN, Stewart WG. Segmental Fracture of the Femur. JAMA. 1965;194(4):354–356. doi:10.1001/jama.1965.03090170032011
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