Open Book on the Water Slide: A Case Series of APC2 Pelvic Ring Injuries from High-Energy Aquatic Accidents
Adeeb Algaith, Kapil Soni, Attila Mácsai, Lilla Sándor, Ákos Csonka, Endre Varga, Petra Hartmann

TL;DR
Waterslides can cause severe pelvic injuries similar to car accidents, especially in overweight individuals, requiring careful diagnosis and treatment.
Contribution
Identifies waterslides as a distinct cause of APC2 pelvic injuries and highlights challenges in their diagnosis and treatment.
Findings
All four patients had APC2 pelvic injuries from waterslides and were overweight or obese.
Pelvic binders helped reduce diastasis but could mask posterior instability in some cases.
Surgical fixation was necessary, with early mechanical failure in some patients using short anterior plates.
Abstract
Background and Objectives: Pelvic ring injuries with symphyseal disruption are classically associated with high-energy mechanisms such as motor vehicle collisions. Recently, waterslides have emerged as an underrecognized but distinct source of severe pelvic trauma. Waterslide-related pelvic trauma represents a distinct biomechanical entity characterized by a supine or semi-supine body position at splashdown, extreme forced hip abduction, asymmetric lower-limb positioning, and abrupt hydrodynamic deceleration. The high descent velocity, abrupt hydrodynamic deceleration, and forced hip abduction at water entry may combine to generate open-book-type pelvic injuries. Evidence guiding diagnosis and surgical management in this setting remains scarce. Materials and Methods: We retrospectively analyzed a consecutive series of adult patients sustaining waterslide-related anterior–posterior…
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Taxonomy
TopicsPelvic and Acetabular Injuries · Spinal Fractures and Fixation Techniques · Abdominal Trauma and Injuries
