Hackensack University Medical Center Case Study: Full Trauma Activation with Multiple Orthopedic Injuries

Patient returns to carpentry work after motorcycle accident causes orthopedic traumas involving both femurs and spine

Julie Keller, M.D., chief of orthopedic trauma at Hackensack Meridian Hackensack University Medical Center, successfully treated multiple orthopedic injuries complicated by additional trauma in a 58-year-old man who was in a motorcycle accident.

The patient, who struck a car and then a mail truck while driving a motorcycle, experienced loss of consciousness at the scene presented with a visible open right femur fracture, as well as deformity of the left femur.

He was brought in as a full trauma activation, and found to have multiple injuries, including an open right femur fracture, a comminuted left distal femur fracture, left sacroiliac dissociation with associated sacral fracture, right pubic rami fractures, multiple rib fractures and multiple spine fractures.

The patient became hypotensive and tachycardic soon after arrival. He was also found to have a mesenteric injury for which he underwent exploratory laparotomy on the day of admission. The patient was treated provisionally for his orthopedic injuries with external fixation of the left femur, and irrigation and debridement, and open reduction and internal fixation of the right femur.

At baseline, the patient was reportedly active and ambulatory. He works as a carpenter and was independent in his daily activities. He does have a history significant for right total knee arthroplasty.

The patient had a prolonged course in the SICU, with respiratory failure requiring tracheostomy. After being stabilized, Neurosurgery performed surgical stabilization of his spine fractures. He then underwent ORIF of his left femur fracture and pelvic ring injuries. After he was stabilized and optimized in the hospital, he was discharged to a rehabilitation facility.

The patient underwent intensive inpatient rehabilitation, then transferred to outpatient rehabilitation. He regained complete independence and is now reportedly in the best shape of his life. He currently bikes, lifts weights and has returned to work.

Learn more about innovative orthopedic care at Hackensack University Medical Center.