Year: 2025 | Month: August | Volume: 12 | Issue: 8 | Pages: 243-249
DOI: https://doi.org/10.52403/ijrr.20250828
Management of Polytrauma in Limited Resources: A Case Report and Literature Review
Elizabeth Angelina Maharani Chandra1, I Made Oka Mahendra2, Su Djie To Rante2,3
1Faculty of Medicine, Maranatha Christian University, Bandung, Indonesia,
2Department of Orthopedics and Traumatology Siloam Hospital Kupang, Indonesia,
3Faculty of Medicine and Veterinary Medicine, Nusa Cendana University, Kupang, Indonesia
Corresponding Author: Elizabeth Angelina Maharani Chandra
ABSTRACT
Background: Polytrauma is widely known with high mortality and morbidity, especially in developing countries. Effective management requires a multidisciplinary to improve patient outcomes. The case report highlights the importance of live-saving interventions and adherence to trauma management principles, even in rural areas with limited resources.
Case Report: A 27-year-old woman sustained with multiple injuries including moderate trauma brain injury and fractures of the left middle-third proximal humeral, right middle-third distal radius, bilateral middle third distal femur, left neck femur, inferior pubic symphysis and right first posterior rib. Emergency surgery was performed and she was admitted to Intensive Care Unit (ICU). She made a good recovery despite complication such as brachial plexus injury in right hand and peroneal nerve injury on the right foot. She was discharged two weeks later.
Discussion: Managing of polytrauma is particularly challenging due to the absence of a universally accepted treatment protocol. This patient had an Abbreviated Injury Scale (AIS) ≥ 3 in multiple organs (head, thorax, extremities), systolic blood pressure (SBP) ≤ 90 mm Hg, and Injury Severity Score (ISS) of 45, categorizing her as unstable (grade III). The application of Damage Control Orthopedics (DCO) principles led to favorable outcomes.
Conclusion: In resource-limited rural settings, timely emergency response, accurate clinical decision-making, access to essential medical resources, and trained personnel are critical to reducing morbidity and mortality polytrauma cases. This case underscores the effectiveness of DCO in managing complex trauma.
Keywords: Polytrauma, Multiple fractures, Damage Control Orthopedics
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