44 years old man was strucked by ambulance while riding motorcycle. he was brought to RSDS 6hours after collission. primary survey showing shock with transient response to resuscitation. there was several blunt injury around his abdomen and chest, also with open wound in his knee and lower leg. the femur looks extremely engorge with hard consistency. the distal pulsation cannot be evaluated but shows 98% saturation. orthopaedic damage controlled was done by putting EF with fasciotomy of the femur
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