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7771 Surgery

A 40-year-old construction worker is pulled from the rubble after a building collapses and pins his right lower leg. X-rays in the emergency department reveal a comminuted fracture of the right tibia and fibula. The dorsal pedis and posterior tibial pulses are palpable. The patient complains of severe pain that is accentuated with dorsiflexion of the foot. The calf feels tense. What is the appropriate step?

AORIF of fracture
BORIF of fracture plus three-compartment fasciotomy
CClosed reduction and observation
DORIF only if pulses become weak
Surgery
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