Hemodynamically Unstable Pelvic Injury Case submitted by Chip Routt, MD - Harborview, Seattle
Case 2
The patient is a 24 yo male injured in an auto accident. There was a
right SI joint injury and small right iliac crest fracture associated with
a significant degloving injury. There were also right comminuted pubic ramus
fractures and significant instability of the right knee.
Initially angio embolization was performed on the right iliac system. The
patient remained hypotensive, tachycardic and the hematocrit was 24. Angiography
was followed in the operating room by an application of an anterior pelvic frame
(made from a femoral distractor) and iliosacral screw reduction/fixation.
Following these procedures, the patient became hemodynamically stable.
The knee injury which consisted of a complete disruption of the ACL, PCL and MCL
was treated surgically at another time.
