Multidisciplinary Repair of Bilateral Vulvar Lacerations Associated With Open Pelvic Ring Injury After Motorcycle Trauma in a Young Nulligravid Woman: A Case Report

Background: Non-obstetric vulvar trauma is uncommon, yet in high-energy injury it may signal deep disruption, contamination, occult bleeding, and psychosexual morbidity. Examination must respect fracture stability, pain, dignity, and trauma priorities. Case presentation: A 21-year-old unmarried nulligravid woman was referred after falling from a motorcycle and being struck by a car. She presented with pelvic pain and bilateral vulvar wounds. On arrival she was conscious and stable; blood pressure was 110/66 mmHg, heart rate 92 beats/minute, and oxygen saturation 100% with nasal cannula. The abdomen was soft and non-tender; conjunctival pallor was present. External genital inspection showed bilateral vulvar lacerations without active bleeding; further examination was limited because repositioning was unsafe. FAST demonstrated approximately 500 mL of intraperitoneal fluid, and hemoglobin was 7.4 g/dL. Imaging confirmed bilateral pubic ramus fractures with sacroiliac joint widening. Initial care included oxygen, pelvic stabilization, skeletal traction, antibiotics, analgesia, tranexamic acid, and transfusion as indicated. During orthopedic surgery, vulvar exploration revealed a 10 x 4 x 3 cm right labia majora laceration and a 6 x 2 x 1 cm left labia minora laceration. Debridement and layered interrupted repair with Vicryl 2-0 achieved anatomical closure. Pelvic fixation stabilized the pelvis. The wound healed, pelvic pain improved, and gynecologic follow-up was discontinued after recovery. Conclusion: Vulvar laceration with pelvic fracture should be managed as complex trauma, not an isolated wound. Care requires respectful genital assessment, coordinated operative timing, sound repair, infection prevention, and later attention to urinary, sexual, functional, and reproductive recovery.