Abstract
BackgroundMajor pelvic trauma (MPT) with traumatic hemipelvectomy (THP) is rare, but it is a catastrophic health problem caused by high-energy injury leading to separation of the lower extremity from the axial skeleton, which is associated with a high incidence of intra-abdominal and multi-systemic injuries. THP is generally performed as a lifesaving protocol to return the patient to an active life.Case reportA 12-year male patient exposed to major pelvic trauma with bilateral THP survived the trauma and multiple lifesaving operations. The anterolateral thigh flap is the method used for wound reconstruction. The follow-up was ended with colostomy and cystostomy with wheelchair mobilization. To the best of our knowledge, there have been a few bilateral THP reports, and our case is the second one to be successfully treated with an anterolateral thigh flap.ConclusionMPT with THP is the primary cause of death among trauma patients. Life-threatening hemorrhage is the usual cause of death, which is a strong indication for THP to save life.
Highlights
Major pelvic trauma (MPT) associated with traumatic hemipelvectomy (THP) was described first by Turnbull in 1978 [1]
MPT with THP is the primary cause of death among trauma patients
Life-threatening hemorrhage is the usual cause of death, which is a strong indication for THP to save life
Summary
Major pelvic trauma (MPT) associated with traumatic hemipelvectomy (THP) was described first by Turnbull in 1978 [1] Rare, it is a catastrophic health problem caused by high-energy injury leading to separation of the lower extremity from the axial skeleton from two joints [the symphysis pubis and the sacroiliac (SI) joint]. Exploration reveals incomplete open separation of the left limb from the sacroiliac joint and symphysis pubis, complete thrombosis of external and internal iliac vessels, and major soft-tissue destruction, including transection of sciatic and femoral nerves. After 12 h, the patient was stabilized, and computed tomography angiography of the pelvis was performed and it revealed disruption of the right sacroiliac joint and symphysis pubis with only some ligamentous attachment in addition to the absence of blood flow to the right lower extremity (Fig. 1c and d). On day 128, the wound became fully granulating (Fig. 2d and e), and the patient was admitted to a specialized center for skin grafting (Fig. 2f )
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