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Comprehensive Trauma Summary Date of Accident: 28 June 2026 Mechanism of Injury The patient sustained a high-energy traumatic injury in a road traffic accident resulting in multiple orthopedic, thoracic, abdominal, and solid organ injuries. Orthopedic Injury Displaced fracture of the humeral shaft requiring Open Reduction and Internal Fixation (ORIF) with a titanium plate and screws. Surgical incision closed with approximately 30+ skin staples. Ongoing postoperative rehabilitation for restoration of shoulder, elbow, wrist, and hand function. Abdominal Injuries Liver Injury AAST Grade II liver injury Intraparenchymal hematoma involving Segment VIII measuring approximately 70 × 38 mm. Mild surrounding edema. No active contrast extravasation (no active bleeding). Right Kidney Injury AAST Grade I renal injury Non-enhancing laceration/contusion involving the upper pole of the right kidney measuring approximately 30–38 mm. Small perinephric hematoma. No urinary leakage. No hydronephrosis. No active bleeding. Hemoperitoneum Mild hemoperitoneum with high-density fluid extending into the pelvis, consistent with traumatic internal bleeding. Managed conservatively due to hemodynamic stability. Retroperitoneal Hemorrhage Mild hemorrhagic fluid present within the right retroperitoneal space secondary to renal injury. Thoracic Injuries Rib Fracture Hairline fracture involving the posterior right rib. Hemothorax Mild right-sided hemothorax. Minimal left-sided hemothorax. Pulmonary Injury Bilateral lung contusions with areas of collapse/consolidation secondary to blunt chest trauma. Other CT Findings The following structures showed no significant traumatic injury: Spleen Pancreas Gallbladder Biliary system Left kidney Adrenal glands Major abdominal vessels Urinary bladder Prostate Bowel loops Mesentery No abdominal lymphadenopathy Follow-up CT Findings Repeat CT demonstrated: No significant interval worsening of injuries. No new active hemorrhage. Stable liver and kidney injuries. Mild increase in surrounding edema, consistent with the normal healing response. Why Orthopedic Surgery Was Delayed Definitive fixation of the humerus fracture was postponed until trauma and gastrointestinal surgeons confirmed: Stable hemoglobin levels. No ongoing internal bleeding. Stable liver and kidney injuries. Patient fit to undergo general anesthesia safely. Potential Complications (Monitored During Recovery) Orthopedic Delayed union or nonunion of the humerus. Infection. Implant failure. Elbow and shoulder stiffness. Radial nerve dysfunction. Muscle weakness. Liver Injury Delayed bleeding. Expanding hematoma. Bile leak (not present on CT). Infection or abscess (rare). Kidney Injury Delayed bleeding. Persistent hematuria. Urinary leak (not present). Hypertension (rare long-term complication). Chest Injuries Pneumonia. Persistent pleural effusion. Delayed resolution of hemothorax. Reduced lung expansion due to pain. General Trauma Deep vein thrombosis (DVT). Reduced mobility. Deconditioning requiring physiotherapy. Management The injuries were managed non-operatively, except for surgical fixation of the humerus fracture. Close observation, serial blood investigations, repeat imaging, pain management, respiratory care, and physiotherapy were undertaken. Prognosis The overall prognosis is good, as: Liver injury was Grade II. Kidney injury was Grade I. No active internal bleeding was identified on CT. Follow-up imaging showed stable injuries. Surgical fixation of the humerus was successfully performed. Young age and continued abstinence from smoking improve the likelihood of complete recovery. Estimated Healing Timeline Liver: 6–8 weeks (sometimes up to 3 months). Kidney: 4–6 weeks. Rib fracture: Approximately 6 weeks. Lung contusions/hemothorax: Several weeks to a few months. Humerus fracture: Initial union around 8–12 weeks, with remodeling and strength recovery continuing for several months. Physiotherapy is essential for regaining full function.