Presentation
Road traffic accident (RTA) six months ago.
Patient Data
The right pelvis is displaced superiorly.
The right sacroiliac joint is completely disrupted.
An open-book fracture of the symphysis pubis is noted (distance is more than 2.5cm).
The right pubic body is displaced superiorly.
Fractures are seen in the left pubic body and left inferior pubic rami.
The right hip joint is displaced superiorly. The bone density of the right femoral head is decreased.
A left-sided colostomy and suprapubic cystostomy are seen in situ.
Soft tissue swelling is observed around the right pelvis.
Calcification is observed along the right lower paravertebral lumbar region.
Multiple metallic structures are seen in the left lower and right upper part of the pelvis - foreign bodies.
Conclusions:
complex pelvic fracture
right-sided vertical shear fracture with superior displacement of the right pelvis
open-book AP compression fracture (type III)
comminuted fracture in the left pubic body and left inferior pubic rami - lateral compression fracture
soft tissue swelling around the right pelvis
Case Discussion
This patient experienced a very serious road traffic accident (RTA) six months ago. In addition to pelvic trauma, he sustained bladder and urethral injuries, which were surgically managed (the patient could not provide any documentation). However, he refused surgical procedures for his pelvic trauma and returned to his village. There, he consulted a herbal practitioner for his pelvis, which worsened day by day. Eventually, he decided to consult an orthopedic surgeon.
Pelvic fractures are among the most complex and serious injuries associated with high-energy blunt trauma. Proper classification of the injury is crucial for its management. The Young and Burgess classification combines the mechanism and stability of the fracture. It is also important to assess visceral, genitourinary, and bowel complications.
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