Changes in the Management of Femoral Shaft Fractures in Polytrauma Patients: From Early Total Care to Damage Control Orthopedic Surgery

Delayed Internal Fixation of Femoral Shaft Fracture Reduces Mortality Among Patients with Multisystem Trauma

“…Hypoperfusion resulting from trauma may prime the immune system for an inflammatory response if such treatment is undertaken prior to adequate resuscitation and can lead to substantial end-organ injury 61,62 . The realization of this phenomenon has led to the description of so-called ''damagecontrol orthopaedics,'' whereby definitive treatment is delayed until resuscitation of the patient has been adequately achieved 13,42,63,64 . Our findings are consistent with this approach and signify the potential benefits that may be realized with delays in operative femoral fracture fixation of just twelve hours, particularly for patients with associated abdominal injuries.…”

Dynamic Screw Systems without Image Intensifier: Early Observations in Eight Consecutive Patients

“…Early surgical stabilization, including damage control surgery however has documented advantages and is the norm in Western societies [12][13][14][15][16]. Early surgical stabilization fosters easier and more accurate reduction with the tendency for better healing, and improved outcomes; decreases the rates of ARDS, fat embolism syndrome, multiple organ failure and late sepsis, and the incidence of other fracture related complications.…”

Competing Priorities in the Brain Injured Patient: Dealing with the Unexpected

“…49,50 Orthopedic "damage control" strategies have evolved in order to assist in early management of skeletal trauma in multiply injured patients with TBI who may be unable to tolerate traditional operative approaches or may not even be stable enough to leave their intensive care bed. 34,51 The clinical syndrome of fat embolism can influence the clinical course in the multiply injured patient, especially following long bone extremity fracture fixation. 52 Although early fracture fixation is thought to minimize the risk of this occurrence, some experimental studies show that intramedullary nailing of femoral fractures and subsequent liberation of bone marrow contents may have a negative influence on the central nervous system function.…”