Abstract
Anal sphincter injuries, often accompanying perineal trauma, are closely associated with pelvic fractures (PFs). If unrecognized and untreated, these injuries can lead to sepsis and fecal incontinence. We present the case of a 25-year-old male patient who sustained severe trauma, resulting in unstable open PFs and associated perineal injuries, including anal sphincter damage. The patient was managed with an early diverting colostomy to prevent pelvic sepsis, followed by staged reconstruction of the pelvic ring. This case underscores the importance of a systematic and thorough approach to managing sphincter injuries in post-trauma care. Clinicians must maintain a high index of suspicion for perineal injuries in patients with open PFs, as early intervention can significantly improve functional outcomes.