Multiple Extremity Injuries After Motorcycle Accident

Abstract

A 35-year-old male is involved in a motor vehicle accident (MCA) and is brought in by paramedics complaining of severe pain in his right leg and arm. In the emergency department, 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+. 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+. There is no tenderness or deformity in his left thigh or left lower leg. He also has tenderness to palpation of his right clavicle and on auscultation; a faint bruit is heard underneath the right clavicle. X-ray imaging confirms a right clavicle fracture, right mid-shaft humerus fracture (Fig. 30.1), a right femur fracture, and a right tibia and fibula fracture. X-rays of the left knee are negative.