Case 1

28 y/o male s/p MVA Nov 2008. Treated at outside facility for R distal femur fracture. He reports R knee pain prior to accident. Has undergone multiple irrigation and debridements since for presumed infection and nonunion. Presents with large wound, pain, and instability at distal femur. Denies involuntary weight loss or other consitutional sx.

PE: Large foul-smelling fish-mouth shaped wound on distal lateral R thigh w purulence and palpable bone. Gross instability at distal thigh w crepitus. Neurovascularly intact, no palp inguinal LAN.