Pedestrian vs motor vehicle
Today’s case we have this 66 year old male involved in a pedestrian vs motor vehicle! He was intoxicated at the time and ran across the street. He was hit by a bus and dragged approximately 60 feet across the road. Buckle up (no pun intended) because there are a ton of injuries! He sustained 12 separate fractures in his pelvis. His right femur was fractured in 3 places, creating 4 pieces, and left femur into 2 pieces. His left and right tibia and fibula each sustained a single fracture. And on top of all these bone problems, he has these eye catching avulsion/degloving of basically bilateral lower extremities. So what do we do with this one? Well that’s easy...OR! I think the easiest way is to get this guy to sleep and X-RAY those lower extremities/pelvis to assess the situation. After that, figure out the neurovascularity of the distal parts of the legs. Then it’s time for initial surgical management, including major debriding and possibly amputation. I don’t think surgical closure/grafting should be attempted the first go around due to the inflammatory processes inhibiting the initial healing cascade. Therefore, his wounds should be left open and carefully managed for a grafting surgery at a later date. The healing process for this type of injury is definitley a marathon, not a sprint (again, no pun intended). Hopefully this injury will allow him to reassess his life and have more responsibility when he decides to have a few drinks!
Source: https://instagram.com/p/BhXvgRRAZgs/We use to see these injuries all the time (not to that degree) but ETOH pedestrian versus auto, bus, motorcycle. Probably this chap had more than a couple of drinks. I know his injuries are severe but I always feel sorry for the driver who has to live with the shock of running another human over..it must leave them scarred. Thanks for sharing this interesting case.
