Case 2

Patient: 31-year-old woman.

Incident: While riding an MPWC, she was hit from the left by another MPWC.

Injuries: Severe pain in lower back; laceration to left elbow, with bony fragments visible; unstable pelvis; two deep puncture wounds to left lateral thigh.

Investigations: Plain x-rays showed a comminuted fracture of the olecranon and a comminuted fracture of the left ileum. Computed tomography scan of the pelvis showed a tract from the thigh wounds to the ileum. The fracture of the ileum extended from the anterior superior iliac spine to the sacroiliac joint. There was a moderate amount of displacement. Urethrogram was normal.

Management: Plating of the three ileum fragments; plate and K-wires inserted into the olecranon (10% of which was removed); delayed wound closure.

Outcome: She was discharged home after 56 days in hospital. Four months after the accident, she still had a limited range of movement of the elbow.