Massive skeletal trauma in renal transplant patients

A review of 251 renal transplants done at the Vanderbilt University Medical Center since October 1962 revealed three patients who had suffered subsequent skeletal injuries sufficient to cause hospitalization. In a 37-year-old woman, a closed fracture of the pelvis healed satisfactorily in the usual period of time. In a 30-year-old man, closed fractures healed well, but there was prolonged delay in the healing of massive open wounds resulting from crushing injuries of the lower extremities. He required prolonged hospitalization, but satisfactory result was achieved after early amputation and close cooperation between orthopedic and renal teams. No significant alterations in the function of either patient's transplanted kidney occurred. It is postulated that severe trauma in transplantation patients may become more common in the future, and certain guidelines for its management are set forth. With close cooperation between the orthopedic surgical and medical renal teams, a successful outcome can be expected.