Fracture in a middle-aged man: uncovering the inside story

A 41-year-old man with a 4-year history of maintenance haemodialysis presented to the emergency department with painful disability of his right arm after a falling accident from 3-step stairs. Physical examination revealed local swelling, deformity and tenderness of the right arm. Radiography demonstrated a transverse and displaced fracture of the right distal humerus (figure 1). Unexpectedly, …