Abstract
BackgroundTraumatic hemipelvectomy is a catastrophic fracture of the pelvis as a result of high-energy trauma, such as in a car accident. There have been few case reports of traumatic hemipelvectomy because many of these patients die before they are transferred to a hospital. However, an increasing number of patients are being saved and admitted to hospital due to improvements in resuscitation and the emergency response system. Accordingly, there has been a growing body of reports on the management and reconstruction of traumatic hemipelvectomy.Case presentationA healthy 20-year-old Japanese man was trapped beneath a 3-ton steel frame while working on a crane. We describe here a very challenging case of traumatically induced bilateral partial hemipelvectomy with successful reconstruction of our patient’s pelvis using a unilateral anterolateral thigh flap.ConclusionTo the best of our knowledge, there have been few reports of bilateral hemipelvectomy and our case is the first to be successfully treated with a unilateral anterolateral thigh flap.
Highlights
Traumatic hemipelvectomy (TH) is a rare catastrophic fracture of the pelvis as a result of high-energy trauma, such as in a car accident
We present here a very challenging case of traumatically induced bilateral partial hemipelvectomy with successful reconstruction of the pelvis using a unilateral anterolateral thigh flap
After crossover graft of the axillary-femoral artery, another hemorrhage was confirmed in his retroperitoneum, which was thought to be due to the external iliac artery injury
Summary
Traumatic hemipelvectomy (TH) is a rare catastrophic fracture of the pelvis as a result of high-energy trauma, such as in a car accident. We present here a very challenging case of traumatically induced bilateral partial hemipelvectomy with successful reconstruction of the pelvis using a unilateral anterolateral thigh flap. Case presentation A healthy 20-year-old Japanese man was trapped beneath a 3-ton steel frame while working on a crane He was rescued by his coworkers and exhibited constant bleeding from the right side of his lower abdomen when the ambulance arrived. On day 2, additional debridement of the right side of his lower abdomen was performed. Repeated debridement was necessary because of the ongoing infection; we performed debridement a total of six times (Fig. 3) Part of his ilium and acetabulum was left and the posterior ilium was fully exposed after the extensive debridement.
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