Clinical images: Trauma

Major and minor injuries in primary care. By Dr Philip Marazzi.


This middle-aged woman sustained a painful scald to her chest when she spilled a cup of hot tea onto herself. The skin blistered but the injury was not too deep. The wound was dressed by the practice nurses and healed very well, with no significant scarring.


Finger amputation

This young man was working as a gardener. He accidentally cut off his little finger with a pair of loppers. His colleague had the presence of mind to pick up the finger and put it into a bag of ice for the journey to hospital. It was reattached and has since healed well.


Skull fracture

This young man was enjoying his night out. He had no recollection of events, but believes he became involved in a fight and sustained this injury. He was taken to A&E where X-rays revealed a fracture of the frontal sinus. He was glued up and required no further treatment.


Radial fractures

This 20-year-old lost control of his car, swerving off the road and hitting a tree. He was very lucky that the only injury was to his right forearm. The fracture was badly comminuted. During surgery, he also had decompression of his carpel tunnel due to the amount of swelling present. This image shows the external fixators holding the whole area securely and hopefully allowing optimal healing.


Spider bite

This man returned from Thailand where he had been bitten on the hand by a spider. He thought that it was a black widow. He developed an abscess at the site which required incision and drainage a couple of days later. He was then treated with broad spectrum antibiotics. This necrotic area on the base of the abscess cavity subsequently healed well.



This middle-aged woman has problems with a variety of musculoskeletal pains. She became rather disillusioned by our inability to control her symptoms and went to an alternative medicine practitioner. He carried out a procedure using a series of suction cups producing this bizarre pattern of bruising. Unfortunately, it did not help her.



Fractured neck of femur

This elderly woman fell at home. She was unable to weight bear. Her right leg was short and externally rotated, and an attempt to move the hip produced considerable pain and crepitus. She had a broken hip and osteoporosis, but has done well following surgery.


Torn head of biceps

This 45-year-old man tore the long head of biceps. This occurred while he was lifting a heavy weight clearing out his garage. There were no obvious predisposing factors for the injury. He was able to demonstrate this as shown producing a ‘Popeye’ type biceps swelling. No action was required and he made a good recovery.

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