External Fixation as a Bridge to Intramedullary Nailing for Patients with Multiple Injuries and with Femur Fractures: Damage Control Orthopedics

Abstract

EF is a viable alternative to attain temporary rigid stabilization in patients with multiple injuries. It is rapid, causes negligible blood loss, and can be followed by IMN when the patient is stabilized. There were minimal orthopedic complications.

Prevalence of chest trauma, associated injuries and mortality: a level I trauma centre experience

“…Even though we have no specific data to clarify the reasons why some patients went acutely to the operating room and others did not, it seems that the concept of "early total care" [14] is once again under reconsideration. Studies have shown that "borderline patients", that is, patients with severe head, thoracic or chest trauma and patients with high Injury Severity Score [17], have better chances of survival when the treatment approach of "damage control" [21] is applied.…”

Fraturas ipsilaterais de fêmur e pelve (quadril flutuante): análise prospectiva de 16 casos

“…Nos pacientes com fratura aberta, adotamos protocolo padrão de antibioticoprofilaxia, associando-se aminoglicosídeo por 48 horas nas fraturas 3A de Gustilo et al (15)(16) . Profilaxia das complicações tromboembólicas foi aplicada de lesões músculo-esqueléticas devem ser adiados até que haja adequada recuperação do trauma inicial (10,21) . Abordagem multidisciplinar é fundamental na fase aguda de ressuscitação dos pacientes, uma vez que tanto a lesão do anel pélvico quanto a fratura do fêmur podem provocar instabilidade hemodinâ-mica (10) .…”

“…Abordagem multidisciplinar é fundamental na fase aguda de ressuscitação dos pacientes, uma vez que tanto a lesão do anel pélvico quanto a fratura do fêmur podem provocar instabilidade hemodinâ-mica (10) . Nesse contexto, a utilização de dispositivos de fixação externa vem sendo demonstrada como medida útil e eficaz no manejo primário de fraturas femorais e pélvicas em pacientes com múltiplas lesões associadas (2,21) . Independentemente do padrão e da gravidade das lesões ortopédicas, o objetivo do tratamento na fase de ressuscitação é obter equilí-brio hemodinâmico e impedir danos adicionais ao paciente.…”

Current Concepts of Respiratory Insufficiency Syndromes After Fracture

“…In approximately 5% of fractures of the long bones in the leg, the patient is 'physiologically unstable' after initial resuscitation because of coagulopathy, haemodynamic instability, raised intracranial pressure, vascular damage or injury to a solid organ. 87,88 The treatment of these life-threatening conditions takes priority over the orthopaedic injuries in the early stages, and the use of external fixation is advocated, dictated by the requirement for rapid temporary stabilisation of the fracture. If these patients survive, they are also at a much higher risk of ARDS within the first week after injury and it is important Summary of the previous English-language studies which have compared the effects of early operative stabilisation of the fracture (usually within 24 hours) with late or non-operative treatment on the incidence of post-traumatic respiratory complications.…”