Damage-control orthopedics or early total care: What you need to know

Abstract

Patients with multi-system injuries are defined as polytrauma patients and may need multiple surgical procedures from more than one specialty. The importance of evaluating and understanding the resuscitation status of a polytrauma patient is critical. Orthopedic strategies when caring for these patients include temporary stabilization or definitive early fixation of fractures while preventing further insult to other organ systems. This article will define polytrauma, and discuss specific markers used in assessing patients’ hemodynamic and resuscitation status. The decision to use damage control orthopedics (DCO) or early total care (ETC) for treatment of the patient are based on these factors and an algorithm is presented to guide treatment. We will also discuss principles of external fixation and the management of pelvic trauma in a polytrauma patient.