Journal of Trauma and Injury

Case Reports

Supercharging of the axillary nerve with a nerve innervating the triceps in a partial traumatic brachial plexus injury of a 5-year-old child in India: a case report: Sanjay Kumar Giri, Ahana Bandyopadhyay, Santanu Suba; Received August 21, 2025 Accepted November 27, 2025 Published online August 19, 2026; DOI: https://doi.org/10.20408/jti.2025.0203 [Epub ahead of print]

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Abstract PDF: A 5-year-old girl presented with an inability to abduct her left shoulder and flex her left elbow following a fall 1.5 months earlier. Electrodiagnostic studies were suggestive of a partial upper trunk brachial plexus injury. The child was advised to attend monthly follow-up visits with regular physiotherapy and nerve stimulation. At 3 months after injury, elbow flexion had recovered completely, and shoulder abduction had improved to 30°. After an additional month of observation without further clinical improvement in shoulder abduction, a nerve-to-triceps transfer to the axillary nerve was planned in the fifth month. Intraoperatively, the posterior division of the axillary nerve was found to be excitable. To preserve nerve continuity, an end-to-side supercharging procedure was performed using the nerve to the medial head of the triceps to augment the axillary nerve. The postoperative period was uneventful, and physiotherapy was resumed 3 weeks after surgery. Within 7 months of surgery, the patient demonstrated full shoulder abduction. Restoration of shoulder function is a primary goal in the management of brachial plexus injuries. Nerve transfers offer substantial potential for improved functional recovery. In this case, lateral neurorrhaphy of the nerve to the medial head of the triceps to the axillary nerve provided additional motor input, facilitating earlier deltoid recovery. Early surgical intervention in selected cases may contribute to faster and more effective recovery, particularly in the pediatric population.; Summary

Neuroleptic malignant syndrome in a cervical spinal injury patient: a case report: Binayak Deb, Yudhyavir Singh, Shuchi Smita, Sreehari N; J Trauma Inj. 2026;39(2):191-194. Published online June 24, 2026; DOI: https://doi.org/10.20408/jti.2025.0159

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Abstract PDF: Neuroleptic malignant syndrome (NMS) is a rare, idiosyncratic, and potentially fatal complication associated with the abrupt withdrawal of dopaminergic agents or the use of antidopaminergic medications that affect the hypothalamus and basal ganglia. Its hallmark features include severe hyperthermia, altered consciousness, skeletal muscle rigidity, and autonomic instability. We present the case of a young patient with a cervical spine injury who was admitted to the trauma intensive care unit (ICU). The patient developed a persistent high-grade fever that did not respond to standard interventions, which was ultimately attributed to NMS resulting from the administration of neuroleptic medications. Because of a high degree of clinical suspicion and the implementation of prompt therapeutic measures, the patient achieved a favorable clinical outcome. Early diagnosis and timely intervention are crucial in NMS due to its rapid clinical progression, particularly as the use of dopaminergic antagonists becomes more prevalent in ICU settings. This case highlights the diagnostic challenges of managing NMS alongside spinal trauma in the ICU, as NMS often mimics common postoperative and ICU-related complications, necessitating heightened clinical vigilance.; Summary

Original Article

Evaluation of diagnostic performance of PECARN clinical decision rule in children with minor head trauma presenting to the emergency department of a tertiary care center: an observational study: Salooja Sulthana N, Nikhil Paul, Archu MJ, Keerthana Manoharan K K, Linu SM, Visakh S Vinod; J Trauma Inj. 2026;39(2):144-150. Published online April 22, 2026; DOI: https://doi.org/10.20408/jti.2025.0165

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Abstract PDF: Purpose
Minor head trauma is one of the most common reasons for pediatric emergency department visits. Accurate identification of children at risk for clinically important traumatic brain injury (ciTBI) is essential to reduce unnecessary computed tomography (CT) imaging. This study evaluated the diagnostic performance of the PECARN (Pediatric Emergency Care Applied Research Network) clinical decision rule in children with minor head trauma presenting to a tertiary care hospital in South India.
Methods
In this observational study conducted between September 2022 and April 2024, 235 children aged <18 years presenting with head trauma and Glasgow Coma Scale scores of 14–15 were prospectively enrolled. Participants were stratified into age-specific PECARN risk categories. Diagnostic performance was assessed against ciTBI outcomes defined by clinical and radiological criteria.
Results
The PECARN rule demonstrated strong diagnostic performance, with a sensitivity of 82.4%, specificity of 74.1%, and an area under the receiver operating characteristic curve of 0.90 (P=0.01). No cases requiring neurosurgical intervention were missed. Children aged ≥2 years had a higher incidence of ciTBI than those aged <2 years (13.4% vs. 1.8%, P=0.048). ciTBI was significantly associated with loss of consciousness, vomiting, severe headache, and signs of basilar skull fracture (all P<0.001).
Conclusions
The PECARN rule appears to be a reliable and safe tool for evaluating pediatric minor head trauma in Indian emergency settings. Its high sensitivity and negative predictive value support its use in reducing unnecessary CT imaging while accurately identifying children at risk for ciTBI.; Summary

Case Report

Iatrogenic cardiac injury following prehospital needle decompression: a case report: Khalid Ahmed, Rabab Abdelrahman, Murad Alahmad, Ammara Bint I Bilal, Al-jouhara Albaloshi, Mohamed H. Ahmed, Husham Abdelrahman, Hafeez Ulla Lone, Sankar Balasubramanian, Ayman El-Menyar, Sandro Rizoli, Hassan Al-Thani, Talat Chughtai; Received June 17, 2025 Accepted July 15, 2025 Published online March 30, 2026; DOI: https://doi.org/10.20408/jti.2025.0136 [Epub ahead of print]

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Abstract PDF: Tension pneumothorax is a life-threatening condition that necessitates prompt intervention, typically via prehospital needle thoracostomy. However, this procedure carries risks such as cardiac injury. We report the case of a 20-year-old man involved in an all-terrain vehicle accident who presented with a low Glasgow Coma Scale (GCS) score, respiratory distress, and hypotension. Prehospital intubation and left-sided needle thoracostomy were performed for suspected pneumothorax and depressed GCS score. Pulsatile bleeding from the catheter was noted. Imaging in the trauma bay revealed catheter penetration into the left ventricle. Pan computed tomography confirmed the cardiac injury and identified a severe traumatic brain injury. The patient underwent surgical repair of the heart via median sternotomy. He recovered well and was subsequently transferred for rehabilitation. This case highlights the risks associated with emergent, blind needle thoracostomy in the prehospital setting. Improved outcomes depend on refined technique, accurate anatomical identification, and appropriate needle selection.; Summary

Original Article

Changes in severe injuries of child and adolescent pedestrians in child protection zones after the revision of the Road Traffic Act in Korea: a retrospective nationwide observational study: Eun Sook Ryu, Jae Ho Jang, Jae Yeon Choi, Woo Sung Choi, Sung Youl Hyun; J Trauma Inj. 2025;38(4):366-372. Published online December 31, 2025; DOI: https://doi.org/10.20408/jti.2025.0255

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1 Web of Science
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Abstract PDF

Purpose
This study aimed to analyze changes in injury severity among child pedestrians following the implementation of the revised Road Traffic Act (the "Minsik Law") in Korea’s child protection zones on March 25, 2020.
Methods
We conducted a retrospective analysis using the nationwide Emergency Department-based Injury In-depth Surveillance (EDIIS) database. The pre-amendment period (January 2018 to February 2020; n=1,480) was compared with the post-amendment period (March 2021 to December 2023; n=1,085) for pedestrian accident patients under 13 years of age, applying a 1-year washout period to mitigate the effects of the COVID-19 pandemic. The primary outcome was severe injury, defined as an Injury Severity Score (ISS) of ≥15. Multivariate logistic regression was used for the assessment.
Results
A total of 2,565 patients were included. The proportion of severe injuries (ISS ≥15) decreased from 63.1% to 53.6% after the amendment, although this trend did not reach statistical significance (P=0.085). However, after adjustment for age, sex, and other variables, multivariate analysis showed that the post-amendment period was independently associated with a significant 38.4% reduction in the odds of severe injury (adjusted odds ratio, 0.616; P<0.001). A significant shift in the distribution of injury sites was also noted (P<0.005).
Conclusions
The revision of the Road Traffic Act was significantly associated with reduced injury severity among child pedestrians in Korea. These findings provide strong evidence supporting the policy’s effectiveness in improving clinical outcomes and strengthening child safety.

Summary

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What Drives Children’s Satisfaction? An Integrated Assessment of Walking School Commuting Environments in Nanjing Using FCE and SEM
Zhiying Quan, Melasutra Md Dali, Rosilawati Zainol
Child Indicators Research.2026;[Epub] CrossRef

Case Reports

Iatrogenic vascular injury during retrograde intramedullary nailing of a distal femur fracture: a case report: Jeong Seok Choi, JunHyeok Kwon, Yun Ki Ryu, Wonseok Choi, Seonghyun Kang, Jong-Keon Oh, Jae-Woo Cho; J Trauma Inj. 2025;38(4):399-403. Published online December 31, 2025; DOI: https://doi.org/10.20408/jti.2025.0238

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Abstract PDF: We report a case of iatrogenic injury to the lateral circumflex femoral artery following distal femoral nailing in a 72-year-old patient. Postoperatively, progressive thigh swelling developed, but initial contrast-enhanced computed tomography (CT) showed no evidence of vascular injury. The arterial injury was subsequently identified on a follow-up contrast-enhanced CT scan and was successfully treated with angiographic microcoil embolization. This case underscores the critical importance of meticulous awareness of the trajectories of the lateral circumflex and deep femoral arteries during proximal interlocking screw insertion. It also highlights that early postoperative imaging can fail to detect such vascular complications. Therefore, a high index of clinical suspicion is paramount, and repeated imaging should be strongly considered if clinical signs, such as progressive swelling, persist despite initial negative findings.; Summary

Subclavian artery injury following clavicle fracture successfully treated with an urgent conversion to endovascular method: a case report: Jiwon Kim, Jonghwan Moon; J Trauma Inj. 2025;38(4):394-398. Published online December 31, 2025; DOI: https://doi.org/10.20408/jti.2025.0168

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Abstract PDF: Subclavian artery injury is a rare complication of clavicular fracture. This condition most often results from penetrating trauma but may also occur after blunt injury, when bone fragments cause rupture, pseudoaneurysm, dissection, or arterial thrombosis. Subclavian artery injury associated with clavicular fracture occurs in less than 1% of cases and may lead to life-threatening hemorrhage or limb ischemia. We report a case of subclavian artery injury secondary to a clavicular fracture that was successfully managed with endovascular intervention. A 48-year-old man presented to the emergency department after a downhill bicycle crash with a right midshaft clavicle fracture and was scheduled for open reduction and internal fixation (ORIF) 11 days later. Intraoperatively, rupture of a subclavian artery pseudoaneurysm caused massive hemorrhage. Surgical dissection was complicated by severe perivascular inflammation and a high risk of iatrogenic subclavian vein injury. Immediate conversion to an endovascular approach allowed successful hemostasis through femoral artery access and covered stent deployment, after which ORIF was completed. The patient recovered without neurovascular complications and was discharged on postoperative day 5. At 12 weeks, he achieved full shoulder range of motion, and 2-year follow-up angiography showed no stent-related complications. This case underscores the effectiveness of emergent endovascular intervention for ruptured traumatic subclavian pseudoaneurysm when inflammation and risk of iatrogenic injury preclude safe open dissection. A hybrid or rescue endovascular strategy should be considered for similar complex trauma cases.; Summary

Original Articles

Use of the Obstetric Early Warning Score in emergency triage for pregnant trauma patients: a retrospective cross-sectional study on a tool for early hospitalization decision-making: Figen Topalak, Selen Acehan, Salim Satar, Muge Gulen, Sarper Sevdimbas, Kadir Nigiz, Mehmet Gorur, Ali İsa Aslan, Ihsan Dengiz; J Trauma Inj. 2026;39(1):25-33. Published online December 29, 2025; DOI: https://doi.org/10.20408/jti.2025.0104

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Abstract PDF: Purpose
Traumatic injuries during pregnancy present significant challenges for emergency providers, necessitating rapid assessment to ensure the safety of both mother and fetus. Scoring systems that can be applied immediately upon presentation may facilitate early triage and inform disposition decisions. This study evaluated the predictive performance of the Obstetric Early Warning Score (OEWS), Injury Severity Score (ISS), and Revised Trauma Score (RTS) in determining hospitalization needs among pregnant trauma patients admitted to the emergency department (ED).
Methods
This retrospective cross-sectional study included pregnant trauma patients aged 18 years or older who were admitted to a tertiary care ED between January 2019 and December 2022. Demographic, clinical, laboratory, and trauma-related data were collected. OEWS, ISS, and RTS were calculated at admission. The primary outcome was the requirement for hospitalization. Binary logistic regression and receiver operating characteristic (ROC) curve analyses were performed to assess predictive performance.
Results
A total of 316 pregnant trauma patients were included. Hospitalization was required in 14.9% of cases. Higher OEWS (mean, 2.63 vs. 0.33; P=0.001) and ISS (mean, 18.02 vs. 5.04; P<0.001) were significantly associated with hospitalization. In multivariate analysis, OEWS (odds ratio [OR], 1.553; 95% confidence interval [CI], 1.087–2.219; P=0.016) and ISS (OR, 1.170; 95% CI, 1.083–1.264; P<0.001) were independent predictors of hospitalization. ROC analysis demonstrated that ISS had the highest predictive value (area under the curve, 0.783; 95% CI, 0.695–0.870; P<0.001).
Conclusions
Both ISS and OEWS are effective tools for predicting hospitalization needs in pregnant trauma patients. Incorporating these scoring systems into ED triage protocols may enhance early identification of high-risk patients and improve outcomes for both mothers and fetuses.; Summary

Postextubation management in head injury patients at high risk of reintubation in the trauma intensive care unit: a retrospective study: Saeed Mahmood, Temur Baykuziyev, Mohammad Asim, Naushad Ahmad Khan, Ayman El-Menyar, Gustav Strandvik, Sandro Rizoli, Hassan Al-Thani; J Trauma Inj. 2025;38(4):320-326. Published online December 29, 2025; DOI: https://doi.org/10.20408/jti.2025.0050

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Abstract PDF: Purpose
Careful clinical assessment is essential for extubation in patients with acute respiratory failure, and decisions must weigh the potential benefits and risks related to the timing of extubation. This study aimed to characterize the population at high risk for extubation failure and to assess the interventions employed to prevent reintubation in head injury patients admitted to the trauma intensive care unit.
Methods
We retrospectively obtained data from the trauma registry database of traumatic brain injury patients who were intubated and admitted to a trauma intensive care unit in Qatar from January 2013 to December 2015. Regression analysis was performed to examine the association between successful extubation and in-hospital complications.
Results
In total, 297 head injury patients (279 male and 26 female patients) at high risk of reintubation were included in the analysis. The prevalence of agitation and pneumonia in postextubated head injury patients were 10.8% and 4.7%, respectively. After adjusting for confounding variables, successful extubation with the use of a nasal cannula and continuous positive airway pressure was significantly associated with reduced agitation (P=0.001) and a lower incidence of in-hospital complications, including pneumonia (P=0.001) and sepsis (P=0.02).
Conclusions
This study suggests an association between successful extubation, reduced agitation, and a decreased incidence of in-hospital complications such as pneumonia and sepsis. Particular attention and further research should focus on optimizing extubation management for head injury patients.; Summary

Case Reports

Self-inflicted rectal injury triggering acute myocardial infarction: a case report: Muge Gulen, Mehmet Gorur, Salim Satar, Selen Acehan, Ozge Ozcan Abacioglu, Adnan Kuvvetli; Received June 18, 2025 Accepted July 5, 2025 Published online November 20, 2025; DOI: https://doi.org/10.20408/jti.2025.0138 [Epub ahead of print]

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Abstract PDF: A 47-year-old male patient who had self-inserted a rectal foreign body for anal autoerotic purposes was admitted to the emergency department. Thirty minutes after admission, he developed chest pain and profuse sweating. Electrocardiography revealed an acute inferior myocardial infarction. Initially, the patient underwent coronary angiography, and percutaneous transluminal angioplasty was performed for a 100% occlusion of the right coronary artery. Subsequently, under general anesthesia, the foreign body was removed via rectal examination in the lithotomy position. This rare clinical scenario, which has not been previously reported in the literature, highlights the potential for psychological trauma and local rectal injury to act as triggers for myocardial infarction. Respecting patient confidentiality, maintaining a nonjudgmental approach, and implementing a multidisciplinary strategy are critically important for the effective management of such uncommon cases.; Summary

Vertebral artery dissection and homonymous hemianopsia after a cervical spine fracture in a polytrauma patient with hypoplastic contralateral vertebral artery: a case report: Josip Lovaković, Dino Bobovec, Ivan Dobrić, Anko Antabak, Goran Milašin, Dino Papeš; J Trauma Inj. 2026;39(2):173-177. Published online August 22, 2025; DOI: https://doi.org/10.20408/jti.2025.0014

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Abstract PDF: Despite the increasing incidence of vertebral artery injury (VAI), it can often be overlooked during the management of polytrauma patients. Due to its specific anatomical location, the VA is particularly susceptible to both traumatic and spontaneous injuries. Traumatic VAI can result from blunt or penetrating trauma and is frequently associated with cervical spine injuries. An 18-year-old male patient was brought to the emergency department after being struck by a motor vehicle. The patient exhibited altered mental status while remaining normotensive and tachypneic. Notably, there were no visible injuries to the head or neck, though multiple contusions were present on the chest and abdomen. Radiographic imaging revealed a fracture of the transverse process of the seventh cervical vertebra, which caused dissection, thrombosis, and occlusion of the V1 segment of the left VA. Additionally, hypoplasia of the contralateral VA was observed. Given the presence of ultrasonographically confirmed free intra-abdominal fluid and the patient’s newly developed hemodynamic instability, he was urgently transferred to the operating theatre. A grade 3 liver laceration was discovered, and hemostasis was successfully achieved using direct sutures. After regaining consciousness, the patient reported right-sided homonymous hemianopsia accompanied by signs of cerebral ischemia. Following stabilization, he was started on anticoagulant and antiplatelet therapy. Upon discharge and during follow-up, the visual deficit persisted. This case emphasizes the importance of recognizing and managing VAI in polytraumatized patients. Furthermore, the rare combination of contralateral VA hypoplasia and VAI significantly influenced the development of neurological deficits.; Summary

Original Articles

Correlation between bispectral index values and the Glasgow Coma Scale in traumatic brain injury patients: a prospective observational study: Anjum H. Mujawar, Pradnya M. Bhalerao, Sujit J. Kshirsagar; J Trauma Inj. 2025;38(2):97-102. Published online June 30, 2025; DOI: https://doi.org/10.20408/jti.2025.0026

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Abstract PDF: Purpose
Traumatic brain injury (TBI) severity is typically assessed using the Glasgow Coma Scale (GCS). In contrast, the bispectral index (BIS) objectively evaluates a patient’s level of consciousness in an intensive care unit. The primary objective of this study was to evaluate the correlation between GCS and BIS values in TBI patients. Secondary objectives included determining the range of BIS scores corresponding to different levels of consciousness and assessing the correlation among mild, moderate, and severe TBI.
Methods
Sixty patients participated in a prospective observational study conducted at a government tertiary care facility. After obtaining a detailed history and performing a physical examination, each patient’s age, sex, intubation status, computed tomography brain findings, and vital signs were recorded. Subsequently, the patients’ GCS and BIS values were measured at 0, 6, 12, 18, and 24 hours. Quantitative data are presented as mean±standard deviation, while qualitative data are illustrated using frequency and percentage tables. Spearman correlation analysis was employed to evaluate the association.
Results
Spearman correlation analysis demonstrated a strong positive relationship between BIS and GCS at 0 hours (r=0.655, P<0.05), 6 hours (r=0.647, P<0.05), 12 hours (r=0.652, P<0.05), 18 hours (r=0.659, P<0.05), and 24 hours (r=0.648, P<0.05). Moreover, the mean BIS value decreased significantly with increasing severity of head injury.
Conclusions
Similar to the GCS, the BIS correlates with head injury severity and may serve as a complementary tool for predicting outcomes in TBI patients.; Summary

Management and outcomes of open and endovascular aortic repair with blunt traumatic aortic injuries in Western Australia: Amyna Jiwani, Warren D. Raymond, Fernando Picazo-Pineda, Sudhakar Rao, Kishore Sieunarine; J Trauma Inj. 2025;38(2):111-124. Published online June 30, 2025; DOI: https://doi.org/10.20408/jti.2024.0101

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Abstract PDF Supplementary Material

Purpose
Blunt traumatic aortic injuries (TAIs) require timely surgical intervention to prevent death. We described the management and outcomes of polytrauma patients with TAI after open and endovascular repair in Western Australia.
Methods
We performed a retrospective cohort study of patients with TAI admitted to the State Trauma Unit, Royal Perth Hospital from 2008 to 2018. Patient data were obtained from the Trauma Database and supplemented with chart review.
Results
Among 57 patients with TAI, 45 (78.9%) were male, with a mean age of 41 years, and were mainly involved in motor vehicle crashes (89.5%). They had a median Injury Severity Score of 34 (interquartile range [IQR], 21–45) and a median length of stay of 18 days. Concurrent injuries occurred in nearly all patients, including musculoskeletal (56 patients, 98.2%; mainly fractures, 91.2%), central nervous system (33 patients, 57.9%; mostly hemorrhage), injury to the chest cavity (46 patients, 80.7%), and abdominal organs (32 patients, 56.1%). The most common TAI grade was III (56.1%), followed by grade I (22.8%) and grade II (21.1%); all grade IV patients died before vascular consultation. TAI was managed with endovascular surgery (thoracic endovascular aortic repair, TEVAR) in 37 (64.9%, of which early TEVAR was performed in 29 [78.4%]), open surgery in 4 (7.0%), and conservative management in 16 (28.1%). Vascular procedures had a median duration of 81 minutes (IQR, 60–97 minutes). Acute vascular surgery–related complications were infrequent (5.3%), and all occurred post-TEVAR, mainly involving upper limb ischemia that required bypass or stenting within 72 hours of the index procedure. After discharge (52 patients), 3 patients were lost to follow-up regarding surgical survival, and late complications occurred in 6 of 48 vascular surgery patients (12.5%), who all underwent TEVAR.
Conclusions
TAI patients who received a vascular surgery review and were managed either conservatively or surgically showed favorable postdischarge survival rates and surgical results.. Patients with grade II or III TAI who underwent endovascular repair had favorable short- and long-term outcomes.

Summary

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Aberrant left vertebral and aberrant right subclavian arteries in blunt thoracic aortic injury patients: A multicenter registry study
Sean Rodriguez, Chase Caswell, Benjamin W. Starnes, Elina Quiroga, Joseph DuBose, Charles C. Miller, David McGreevy, Ali Azizzadeh, Peter J. Rossi
Annals of Vascular Surgery.2026;[Epub] CrossRef

Case Reports

Complex soft tissue injuries associated with portable charger detonation: four case reports from the war in Ukraine: Eduard Mykolaiovych Khoroshun, Vitaliy Volodymyrovych Makarov, Volodymyr Volodymyrovych Nehoduiko, Maksym Olegovych Malimonenko, Hannah B. H. Wild, Serhii V. Tertyshnyi; J Trauma Inj. 2026;39(2):167-172. Published online June 25, 2025; DOI: https://doi.org/10.20408/jti.2025.0042

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Abstract PDF

This article describes the characteristics and management of injuries associated with ricochet effects due to portable charger detonation. We present a case series of four military personnel who sustained complex soft tissue injuries when portable chargers detonated after being struck by projectiles during combat. All patients were treated by an advanced surgical team at the Military Medical Clinical Center of the Northern Region in Kharkiv, Ukraine, over a 9-month period in 2023. Patient history, physical examination findings, laboratory studies, radiographic imaging, treatment approaches, and early outcomes were examined. All patients were male, with a mean age of 33±0.3 years. Complex soft tissue injury patterns arose when a projectile (such as a bullet or shrapnel) struck the charger, causing ricochet effects while damaging the battery housing and triggering detonation. The anatomical region of injury corresponded to the charger’s placement in the patients’ pockets, namely the thigh or buttock. Characteristic findings included local chemical burns of the skin and subcutaneous tissue, with surrounding ecchymosis. Surgical teams identified three zones of damage associated with this injury pattern: (1) a central zone with the most pronounced burn related changes, covering the smallest area of the three zones; (2) an intermediate zone of soft tissue damage from thermochemical reactions extending beyond the charger’s profile; and (3) an outer zone of ecchymosis. Risks associated with carrying portable chargers during combat have not been well documented. These findings may inform injury prevention strategies for military personnel.

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Reconstruction of a nasal tip defect – a case report
S. V. Tertyshnyi, I. P. Khomenko, S. O. Korol, S. A. Aslanyan, A. O. Kompaniiets, Y. O. Dudchenko
Ukrainian Journal of Military Medicine.2026; 7(1): 203. CrossRef

Preperitoneal pelvic packing as a salvage operation for postoperative retroperitoneal bleeding with hemodynamic instability after the Kocher-Langenbeck approach to the acetabulum: a case report: Doo-Hun Kim, Maru Kim, Dae-Sang Lee, Tae Hwa Hong, Hangjoo Cho; J Trauma Inj. 2025;38(3):285-289. Published online June 25, 2025; DOI: https://doi.org/10.20408/jti.2024.0087

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Abstract PDF: Pelvic fractures result from high-energy trauma, and when accompanied by hemorrhagic shock, the mortality rate increases to 40%. Pelvic fractures are anatomically categorized as pelvic ring disruptions and acetabular fractures, each requiring different treatment methods and approaches. Acetabular fractures, which also result from high-energy injuries, may be accompanied by hemorrhagic shock. Treatment options for pelvic fractures with hemorrhagic shock include angioembolization, preperitoneal pelvic packing (PPP), and emergency laparotomy. In hemodynamically stable patients, early total care may be attempted, and for acetabular fractures (posterior column), the Kocher-Langenbeck approach is the treatment of choice. This case report describes the use of PPP as a salvage operation for postoperative retroperitoneal bleeding with hemodynamic instability following a Kocher-Langenbeck approach for an acetabular fracture with pelvic ring injury. The patient was discharged without postoperative complications such as bone displacement or surgical site infection. While PPP is commonly employed as an initial treatment modality for pelvic fractures with hemorrhagic shock, it may also be valuable in managing postoperative retroperitoneal bleeding with hemorrhagic shock.; Summary

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