A 36 year-old previously healthy and fit man from Thyolo, Malawi, fell from his bicycle. He was seen at Queen Elizabeth Central Hospital (QECH) on the same day and was diagnosed to have a mid shaft transverse fracture of left femur (Fig 2) and an ipsilateral transverse humerus fracture. Both fractures were closed and there were no other injuries. He had stable vital signs on admission and on subsequent measurements. A U-slab was applied to the humerus fracture. The femur fracture was temporarily immobilized with skin traction and pain was managed with oral ibuprofen 400mg twice daily for 5 days. Conservative treatment was agreed upon and he was kept on traction. He was pain free and not taking any analgesia following the course of ibuprofen mentioned. Twelve days after admission he started to complain of increasing pain and tightness in his left thigh. Sensation and motor function
