Orthopedic Considerations in the Pedestrian versus Motor Vehicle Accident Polytrauma Patient

Jason Samona,Robert Colen

doi:10.1155/2012/149847

Jason Samona, Robert Colen

Open Access

https://doi.org/10.1155/2012/149847

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Abstract

Pedestrian versus motor vehicle accidents (PVMVAs) are a common cause of morbidity and mortality around the globe. Past models of PVMVAs assume lower-extremity vehicle contact as the initiating event, with a subsequent predicted injury sequence consisting of a lower extremity injury followed by injury to the body, head, and upper extremities. The term “fatal triad” was first coined by Farley, which described concomitant injuries to the skull, pelvis, and extremity fractures. Over the years, this once well-accepted model of injury has been under scrutiny by numerous orthopedic researchers, and it has lost credibility. This case presentation glaring reveals that the patient incurred which is referred to as the “fatal triad”, in contrast to the commonly circulated thoughts of biodynamic mechanisms of PVMVA fractures. More research in this arena is warranted. This lack of information contributes to the morbidity and mortality associated with such devastating injuries. The overlying theme displayed in the data analyzed in this paper demonstrates the vital importance of the orthopedic surgeon in the management of the PVMVA patient. No matter the particular mechanism of injury, occurrence, or agreed-upon treatment protocol, the role of the orthopedic physician is instrumental to the wellbeing of the PVMVA trauma patient.

Highlights

Pedestrian versus motor vehicle accidents (PVMVAs) are a common cause of morbidity and mortality around the globe
The results demonstrate that many PVMVAs likely do not involve lower extremity contact as the initiating event, and previous models of injury should be disregarded
Despite the high degree of trauma incurred, the patient did not display a femur fractures with the associated pelvic fracture or the “ipsilateral dyad,” which modern medical literature has began to accept as common place among PVMVAs

Summary

Introduction

Pedestrian versus motor vehicle accidents (PVMVAs) are a common cause of morbidity and mortality around the globe. This is commonly seen in the PVMVA victim who incurs severe trauma (such as in this patient), in which visceral, vascular, and/or neurological injury is associated In these cases the treatment protocol is not as widely accepted due to difficulty in evaluation of the patient, varying degrees of severity of multiple injuries, the ability to gauge the life-threatening status of numerous injuries, institutional capabilities, health care provider experience, and so forth. These trauma patients with intraabdominal blood and pelvic fractures present a diagnostic and management challenge for which no clear consensus on the preferred approach exists [12, 13]. Severe cases of entrapment of bowel in the actual fracture site with subsequent gastrointestinal obstruction may occur [14]

Case Report

Findings

Discussion

Conclusion