Internal femoral osteosynthesis after external fixation in multiple-trauma patients

Abstract

(half-pin) osteolysis. Functional recovery was delayed by the presence of other fractures. EF is a simple, quick and safe procedure to stabilise fractures in polytraumatised patients. According to damage control orthopaedic (DCO) concepts, it is possible to replace EF with internal synthesis after an interval as this reduces the risks of internal osteosynthesis when performed in the emergency period. EF can also be maintained as definitive treatment but should a change to internal synthesis be needed, it is possible to do it safely after excluding bone infection.

Surgical Window and Treatment Strategy for Patient with Multiple Fractures Escaping Inflammatory Response: A Case Report

“…The principle of prioritizing resuscitation, operative timing, and strategy are essential to sustain the inflammatory state for improvement of a multi-traumatic patient for better functional recovery and to escape the systemic complications. 13 Management of multi-trauma patients requires a multi-disciplinary approach that must initially ensure stabilization of general condition and vital function . The limitation of this case lacks a wide variety of trauma and only an individualized treatment strategy.…”

Management of Open Fracture

“…Depending on the situation, we should choose the appropriate moment to perform this conversion to internal fixation. In the case of unstable patients, the best moment for internal conversion is given by patient situation and systemic status, but it is safe to perform this conversion in an interval of time lesser than 14 days [45]. There are several articles that calculate the infection rate of the conversion from external to internal fixation, with percentages that move between 0 and 40, depending on the interval between the injury and the definitive internal fixation with a nail, in long bones of the lower limb ( Table 3).…”

Risk Factors of Fracture Nonunion in Polytrauma

“…Одни данные свидетельствуют о лучших результатах при выполнении конверсии остеосинтеза. При политравме с переломом бедренной кости следование тактике DCO с заменой на 4-7 сутки аппаратной фиксации на внутренний остеосинтез значимо уменьшало вероятность несрастания [53] и сокращало средний срок консолидации перелома [54]. Переход на интрамедуллярный остеосинтез не являлся фактором риска несрастания перелома бедренной кости [8] и в 91-97% случаев позволял достигнуть его консолидации в течение 6 месяцев [6,55].…”