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Simultaneous open fracture and rattlesnake bite on the same extremity.

Dustin M Welch1, Cherokee Sauer2, Justin M Martin1

  • 1Department of Emergency Medicine, Baylor Scott & White Medical Center - Temple, Temple, Texas.

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|August 30, 2021
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Summary

Simultaneous open fractures and rattlesnake envenomation require emergent care. This case highlights delayed fracture surgery due to snake bite-induced coagulopathy, a unique Central Texas syndrome.

Keywords:
Envenomationfracturesoff-road motor vehiclesopenrattlesnakesnake bite

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Area of Science:

  • Traumatology
  • Toxicology
  • Emergency Medicine

Background:

  • Open fractures and rattlesnake envenomations are distinct medical emergencies.
  • Concurrent occurrence on the same limb presents a complex clinical scenario.

Observation:

  • A 13-year-old boy experienced a lower-extremity rattlesnake envenomation alongside open tibia and fibula fractures.
  • The incident occurred after a fall from an all-terrain vehicle.

Findings:

  • Rattlesnake envenomation led to coagulopathy, necessitating initial treatment before fracture management.
  • Operative management of the fractures was delayed due to the systemic effects of the venom.

Implications:

  • This case underscores the critical need to address venom-induced coagulopathy promptly in trauma patients.
  • It highlights a specific regional syndrome in Central Texas, requiring tailored emergency treatment protocols.
  • Integrated management strategies are crucial for optimizing outcomes in patients with combined traumatic and envenomation injuries.