A Rare Case of Ipsilateral "Floating Ileum" with Floating Hip and Floating Knee

Concomitant ipsilateral floating hip with floating knee is a very rare injury pattern. Its co-occurrence with ipsilateral complete separation of ileum from pelvic girdle, which can be termed as "floating ileum," is even rarer. These are extremely high energy injuries associated with significant systemic insult adding to the dilemma and complexity in management. There is no mention in the literature about this potentially life-threatening injury combination; hence, an attempt has been made to provide a pathway of the management of this rare but complex injury pattern.

We are presenting a case of 17-year-old male with this menacing amalgamation of injuries along with the challenges associated in the management. The patient had ipsilateral complete disruption of sacroiliac joint along with transverse fracture of acetabulum due to which ileac bone was completely separated from rest of the pelvic bone and was displaced anteriorly, superiorly, and medially. The patient was also having ipsilateral shaft of femur fracture and distal third tibia fracture and acute respiratory distress syndrome as well to further complicate the scenario.

Early damage control, followed by definitive fixation and aggressive rehabilitation, appears to be the safe and acceptable path to reach good clinical outcome.