Traumatic Hemipelvectomy: Surgical and Medical-Legal Aspects

Ricci S

doi:10.4172/2090-2697.1000117

Abstract

Background: Traffic accidents are major causes of disability and mortality due to the increasing number of vehicles, changes in lifestyle and high-risk behavior among the general population. Traumatic hemipelvectomy is a type of exceptional lesion representing 0.6% of all pelvic fractures, although lesions of the lower extremities are more usual than those of the upper extremities.Case presentation: The authors present an unusual case of traumatic left hemipelvectomy, and consider the medical-legal aspects resulting from an accident of a motorcycle driver, which involved a lateral collision between the subject’s motorcycle and a car.Conclusion: With traumatic hemipelvectomy in young subjects difficulties arise at any level and in all medical fields: clinically, surgical and medicolegal

Highlights

Traffic accidents are major causes of disability and mortality due to the increasing number of vehicles, changes in lifestyle and high-risk behavior among the general population
Following a road accident involving a lateral collision between a motorcycle, of which the subject was the driver, and a car, the patient suffered the disarticulation of the left lower limb with left hemipelvectomy
The case presented is one of the rare events of traumatic hemipelvectomy, as it is an unusual type of lesion representing 0.6% of all pelvic fractures, the lesions of the lower extremities are more usual than those of the upper extremities [6]

Summary

Background

Traffic accidents are major causes of disability and mortality due to the increasing number of vehicles, changes in lifestyles and high-risk behavior among the general population [1]. In Italy, in general most categories of vehicles involved in road accidents are passenger cars (66.1%), motorcycles (14.0%), mopeds (5.4%) and bicycles (4.5%) [4]. The authors present an unusual case of traumatic left hemipelvectomy, resulting from an accident involving a motorcycle driver, and consider the related medical-legal aspects. Following a road accident involving a lateral collision between a motorcycle, of which the subject was the driver, and a car, the patient suffered the disarticulation of the left lower limb with left hemipelvectomy. Besides complete amputation of the left lower limb (Figure 1), exposure of the residue of the iliac crest with defined and regular margins (Figure 2) was distinguishable in a hemorrhagic and clear laceration context, which as a result of impact had been torn apart and part of the skin tissue, fat and muscle had been completely removed with the loss of the left testicle. The patient underwent broad-spectrum antibiotic therapy intravenously (ceftriaxone and metronidazole) and analgesic (tramadol, ketorolac, morphine)

Findings

Discussion

Conclusion