Primary Survey

Airway: Clear Breathing: RR 24. No signs chest injury. Circulation: Pulse 90/min, BP 120/70. Dysfunction: GCS 15. No neurology. He has an isolated right lower limb injury, with fracture of the tibia and fibula. He is taken to the operating room for intramedullary nailing of the right tibia.

The procedure is uncomplicated. However, post-operatively the right calf is swollen and quite tense. The patient is complaining of a significant amount of pain in the right leg, despite holding the fracture in a plaster backslab and intravenous morphine. There is pain on ankle movements. Foot pulses are present and capillary refill in the toes is brisk.