Surgery pp 277-285 | Cite as

Multiple Extremity Injuries After Motorcycle Accident

  • Areg Grigorian
  • Kevin W. Rolfe


A 35-year-old male is involved in a motor vehicle accident and is brought in by paramedics complaining of severe pain in both legs and in his right arm. In the ED, the patient is awake and alert. He has an obvious deformity of his right mid-humerus. There are no open wounds in the arm. He has a noticeable wrist-drop on the right and is unable to dorsiflex the wrist or extend the metacarpophalangeal joints. Radial pulse on the right is 2+. On exam of his right leg, there is an obvious deformity of the right thigh as well as in the mid-tibia. There is a 2 cm laceration over his mid-shin, with visible bone exposed. Distal motor and sensory function in his right leg are intact, and pedal pulses are 2+. On the left he has a swollen knee with an obvious effusion. There is no tenderness or deformity in his left thigh or left lower leg. X-ray imaging confirms a right mid-shaft humerus fracture (shown below), a right femur fracture, and a right tibia and fibula fracture. X-rays of the left knee are negative.


Humerus Extremity fracture Polytrauma Open fracture ACL PCL LCL MCL External fixation ORIF 

Suggested Reading

  1. Advanced Trauma Life Support (ATLS) course manual, 8th ed. Chicago: American College of Surgeons; 2008.Google Scholar
  2. Ashford RU, Mehta JA, Cripps R. Delayed presentation is no barrier to satisfactory outcome in the management of open tibial fractures. Injury. 2004;35:411–6.CrossRefPubMedGoogle Scholar
  3. Lieurance R, Benjamin JB, Rappaport WD. Blood loss and transfusion in patients with isolated femur fractures. J Orthop Trauma. 1992;6(2):175–9.CrossRefPubMedGoogle Scholar
  4. Müller EJ, Siebenrock K, Ekkernkamp A, et al. Ipsilateral fractures of the pelvis and the femur–floating hip? A retrospective analysis of 42 cases. Arch Orthop Trauma Surg. 1999;119:179.CrossRefPubMedGoogle Scholar
  5. Pollak AN. Timing of debridement of open fractures. J Am Acad Orthop Surg. 2006;14:S48–51.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Department of SurgeryUniversity of California, IrvineOrangeUSA
  2. 2.Orthopaedic SurgeryHarbor-UCLA Medical Center & Rancho Los Amigos Rehabilitation CenterTorranceUSA

Personalised recommendations