A lower leg injury not to be overlooked
A 62 year old woman, previously fit and well, was admitted to the emergency department after a high speed road traffic crash. She was extricated from the overturned car by the emergency services, immobilised, and transferred to the resuscitation room. Full advanced trauma life support assessment was performed; her vital signs were stable; and her only injury was a swollen, deformed, and painful left lower limb. There were no overlying skin wounds, and there was no neurovascular deficit to the left foot. The emergency department staff were concerned she might have had an ankle fracture, and she underwent standard radiographs of her left ankle, one of which is below (see figure).