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Abstracts / Injury Extra 40 (2009) 183-235 213 SC and IF patients, but recovered by day 5. No significant changes were seen in the MT group. HLA-DR expression was reduced in the MT1st5 group, and post-surgery in SC and IF1st5 groups. None had post-surgery complications related to the systemic inflammatory response.These data support a pragmatic approach in timing definitive fracture surgery based upon the patient's clinical improvement following damage control. There appears to be no associated detrimental effect upon the systemic inflammatory response, even when undertaken less than 5 days from admission and DCS.