Injuries to pelvis, left proximal femur, compound # elbow, both hell and mandible #s.
- Primary survey n once pt is stable - pfn with symphysis & acetabulum plating, with sacroiliac screw, exfixator elbow spanning with debridement, plate calcaneum n k-wire 5th mt, can conserve other calacaneum. Kindly correct if wrong
We did the following surgery, after optimizing the patient general condition, last evening (as a 1st stage procedure): 1. Interlocking nail femur (A2FN), Anterior column plating of acetabulum, 3. ORIF mandible #.
Open fracture of the elbow needed an equal priority as the pelvic and femoral fractures. Our team would have added an elbow spanning fixator.
A little different approach to pelvic injury- Would have done sacral as well as anterior column plating through modified iliofemoral approach (presuming you had used ilio-inguinal approach). Despite the anterior plating of acetabulum, pelvis is still unstable!!! Needs stabilization. At this stage, may be you can add an external fixator for 4 weeks to stabilize pelvis as another internal fixation procedure may not be feasible in her current condition.
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