Management of severe pelvic injury following road traffic accident in a resource-limited setting

Abstract

A 34 year old woman involved in road traffic accident with severe anterior and posterior pelvic fractures with associated soft tissue injury was referred from Wa Regional Hospital 18 hours after the accident to Tania Specialist Hospital in Tamale. Emergency resuscitative measures such as catheterization and management of pain with analgesics were initiated. Computed topography (CT scan) or Magnetic resonance imaging has been recommended as the appropriate tools for risk assessment in such cases however none of this was available at the time of the accident. The only assessment tool available was the C-arm machine which was used to X-ray the pelvis in the follow-ing plane; anterio – posterior pelvic - inlet and pelvic – outlet. Early internal reduction and stabili-zation of pelvis was immediately carried out using the procedure of open reduction and internal fixation (ORIF). Approximately 2 weeks after the operation, radiographs showed signs of healing and the patient was discharged on partial body weight bearing. Upon second review 12 weeks post operatively, complete recovery was accomplished.

Keywords: Anatomy, pelvic injury, motor accident, resource-limited setting, Ghana