Girl with Multiple Fractures: A Unique Case of Polytrauma

Polytrauma is defined as multiple severe injuries with an abbreviated injury scale ≥3 in two or more body regions, often resulting from high-energy trauma. Managing such cases, especially in adolescents with complex fractures, requires a well-coordinated, physiologically guided approach. This case report discusses the management of an 18-year-old female with multiple fractures, including the lower limb, upper limb, and pelvis, following a high-energy fall. Early appropriate care (EAC) was essential in guiding treatment decisions.

An 18-year-old female fell from a height of 20 feet on June 19, 2022, and presented with pain and swelling over both arms, left hip, and thigh, along with an inability to bear weight. Clinical examination revealed a right humerus fracture, complex elbow dislocation (left side), a T-type acetabulum fracture, and a left femur shaft fracture. Initial resuscitation followed advanced trauma life support guidelines. On June 25, 2022, wound debridement and fracture stabilization of the right humerus were performed using an external fixator, and the left elbow dislocation was treated with closed reduction and K-wire fixation. The left humerus fracture was treated with open reduction and internal fixation, and retrograde femoral nailing was done for the left femur. On June 29, acetabular and pubic rami fractures were addressed using the modified stoppa approach. Post-operative rehabilitation focused on non-weight-bearing for 6 weeks and gradual strengthening exercises. After 2 years, the patient had regained full functional ability with a Harris Hip Score of 97 and satisfactory radiological results.

This case highlights the importance of EAC in polytrauma management. Timely interventions, appropriate fracture fixation, and structured rehabilitation led to excellent functional and radiological outcomes. A multidisciplinary approach is crucial in managing such complex trauma cases to optimize recovery.