Scapulothoracic Disarticulation of the Right Upper Limb After a Car-to-Obstacle Collision: A Case Report

This report details the case of a 26-year-old man, victim of a car-to-barrier collision followed by a rollover. The patient, found conscious, was intubated by the pre-hospital team and admitted in severe hypovolemic shock, with extensive injury to the shoulder and right upper limb. After hemodynamic stabilization, the team performed bilateral chest drainage, a massive transfusion protocol, and a forequarter amputation of the right upper limb with ligation of the subclavian vessels, in a joint procedure by the orthopedic and vascular surgery teams. Postoperatively, he remained in the intensive care unit (ICU), developing ventilator-associated pneumonia, treated with meropenem and vancomycin. After 10 days, the patient was transferred to a ward. He was discharged from the hospital after 15 days of hospitalization and continued with outpatient follow-up, where he presented with phantom limb pain initially treated with gabapentin and controlled with physiotherapy. In the end, he was definitively discharged with good healing, pain improvement, and favorable clinical evolution.