Open pelvic fracture can be a devastating injury. This injury is usually associated to other severe injuries of soft-tissues, bone and vascular structures, near the pelvis. Theses injuries are so devastating that usually the patient does not survive to reach medical attention. The mortality rate of these injuries ranges from 41% to 50%. The priorities in the care of these patients are hemorrhage control, debridement and management concomitant soft-tissues injuries, recognition and treatment of distant organ injuries, and management of the pelvic fracture.

One clinical presented and discussed the initial assessment of one 9-year-old boy, run over by a bus, with an open pelvic fracture and a degloving injury to the left lower leg, buttock and flank.

This case showed the difficulties of management of this open pelvic bleeding injury and how do we treat it. This case shows difficulties to identification and bleeding control of this injury and the treatment of degloving injury near the anus.