title: Severely comminuted radius fracture presenting as a signature patterned injury.
abstract: Dilemma still prevails, regarding the exact management of mangled extremity injuries between limb salvage versus amputation, each having there own set of complications. We here present a case of severely comminuted fractures of radius (bag of bones) along with the multiple criss-cross shaped lacerated wounds on the forearm and wrist presenting as a "signature pattern injury" caused by entrapment of the limb in the concrete mixer. MESS score of patient was 8, a score valid for amputation, but contrary, we successfully salvaged the patient's limb with use of radio-carpal distracter. Management of mangled injuries should be individualized, with due consideration to the mechanism and force of injury, associated injuries, and the patient profile.
authors.affiliation: Department of Orthopaedics, Mahavir Hospital, Indore (M.P.), India.
authors.forename: Saurabh
authors.initials: S
authors.lastname: Jain
authors.affiliation: Department of Orthopaedics, Synergy Hospital, Indore (M.P.), India.
authors.forename: Sunil
authors.initials: S
authors.lastname: Rajan
authors.affiliation: Department of Spinal Surgery, Queens hospital, Nottingham, U.K.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Srivastava
keywords: Bag of bones; Radius fractures; bone; fracture fixation; fractures; radius; severely comminuted fracture; signature patterned fracture