Skip to main content

The elderly represent a unique group of trauma patients. How one defines the elderly is an important question. An active, healthy 65-year-old person may be physiologically more fit and better able to tolerate a high energy trauma than a 40-year-old person with multiple medical comorbidities and a sedentary lifestyle. On the other hand, a 75-year-old with a history of myocardial infarction, renal failure, and chronic obstructive pulmonary disease may not be able to tolerate even a slip-and-fall-type injury. Most studies of trauma in the elderly have used an age of at least 65 years in their definition.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Hildebrand F, Pape HC, van Griensven M, Meier S, Hasenkamp S, Krettek C, Stuhrmann M. Genetic predisposition for a compromised immune system after multiple trauma. Shock 2005;24(6):518–22.

    Article  CAS  PubMed  Google Scholar 

  2. Moore FA, Moore EE. Evolving concepts in the pathogenesis of post-injury multiple organ failure. Surg Clin North Am 1995;75:257–277.

    CAS  PubMed  Google Scholar 

  3. Bosse M J. CAQ: Orthopaedic trauma “Damage Control”. J Orthop Trauma 2007;21(1):1–4.

    Article  PubMed  Google Scholar 

  4. Pape H-C, Regel G, Dwenger A, Krumm K, Schweitzer G, Krettek K, Sturm JA, Tscherne H. Influences of different methods of intramedullary femoral nailing on lung function in patients with multiple trauma. J Trauma 1993;35:709–715.

    Article  CAS  PubMed  Google Scholar 

  5. Pape H-C, Grimme K, van Griensven M, Sott AH, Giannoudis P, Morley J, Roise O, Ellingsen E, Hildebrand F, Wiese B, Krettek C. Impact of intramedullary instrumentation versus damage control for femoral fractures on immunoinflammatory parameters: prospective randomized analysis by the EPOFF study group. J Trauma 2003;55(1):7–13.

    Article  PubMed  Google Scholar 

  6. Pape H-C, Schmidt RE, Rice J, van Griensven M, das Gupta R, Krettek C, Tscherne H. Biochemical changes following trauma and skeletal injury of the lower extremity: quantification of the operative burden. Crit Care Med 2000;28:3441–3448.

    Article  CAS  PubMed  Google Scholar 

  7. Pape HC, Giannoudis PV, Krettek C, Trentz O. Timing of fixation of major fractures in blunt polytrauma: role of conventional indicators in clinical decision making. J Orthop Trauma 2005;19(8):551–562.

    Article  PubMed  Google Scholar 

  8. Pape HC, Auf’m’Kolk M, Paffrath T, Regel G, Sturm JA, Tscheme H. Primary intramedullary femur fixation in multiple trauma patients with associated lung contusion: a cause of posttraumatic ARDS? J Trauma 1993;34:540–548.

    Article  CAS  PubMed  Google Scholar 

  9. Tornetta P, Mostafavi H, Riina J, Turen C, Reimer B, Levine R, Behrens F, Geller J, Ritter C, Homel P. Morbidity and mortality in elderly trauma patients. J Trauma 1999;46(4):702–706.

    Article  PubMed  Google Scholar 

  10. Lonner J, Koval K. Polytrauma in the elderly. Clin Orthop 1995;318:136–143.

    PubMed  Google Scholar 

  11. Zeitlow S, Capizzi P, Bannon M. Multisystem geriatric trauma. J Trauma 1994;37:985–988.

    Article  Google Scholar 

  12. Brundage SI, McGhan R, Jurkovich G, Mack CD, Maier RV. Timing of femur fracture fixation: effect on outcome in patients with thoracic and head injuries. J Trauma 2002;52(2):299–307.

    Article  PubMed  Google Scholar 

  13. Nowotarski PJ, CH Turen, RJ Brumback, Scarboro JM. Conversion of external fixation to intramedullary nailing for fractures of the shaft of the femur in multiply injured patients. J Bone Joint Surg (Am) 2000;82:781–788.

    CAS  Google Scholar 

  14. Eastridge BJ, Burgess AR. Pedestrian pelvic fractures: 5 year experience of a major urban trauma center. J Trauma 1997;42:695–700.

    Article  CAS  PubMed  Google Scholar 

  15. Flint L. Babikian G, Anders M, Rodriguez J, Steinberg S. Definitive control of mortality from severe pelvic fracture. Ann Surg 1990;211:703–707.

    Article  CAS  PubMed  Google Scholar 

  16. Rommens PM. Pelvic ring injuries: a challenge for the trauma surgeon. Acta Chir Belg 1996;96:78–84.

    CAS  PubMed  Google Scholar 

  17. Grimm M, Vrahas M, Thomas K. Pressure-volume characteristics of the intact and disrupted pelvic retroperitoneum. J Trauma 1998;44:454–459.

    Article  CAS  PubMed  Google Scholar 

  18. Kadish L, Stein J, Kotler S. Angiographic diagnosis and treatment of bleeding due to pelvic trauma. J Trauma 1973;13:1083–1086.

    Article  CAS  PubMed  Google Scholar 

  19. Holting T, Buhr H, Richter G, Roeren T, Friedl W, Herfarth C. Diagnosis and treatment of retroperitoneal hematoma in multiple trauma patients. Arch Orthop Trauma Surg 1992;111:323–326.

    Article  CAS  PubMed  Google Scholar 

  20. Bone LB, Johnson KD, Weigelt J, Scheinberg R. Early versus delayed stabilization of femoral fractures: a prospective randomized study. J Bone Joint Surg Am 1989;71:336–340.

    CAS  PubMed  Google Scholar 

  21. Oztuna V, Ersoz G, Ayan I, Eskandari MM, Colak M, Polat A. Early internal fracture fixation prevents bacterial translocation. Clin Orthop 2006;446:253–258.

    Article  PubMed  Google Scholar 

  22. Brooks J. “Damage control” surgery techniques used on soldiers. CMAJ 2006;175(7):727.

    PubMed  Google Scholar 

  23. Horst H, Obeid F, Sorenson VJ, Bivins BA. Factors influencing survival of elderly trauma patients. Crit Care Med 1986;14:681–684.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Robert V. Cantu .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Cantu, R.V., Koval, K.J. (2010). Damage Control in Elderly Polytrauma Patients. In: Pape, HC., Peitzman, A., Schwab, C.W., Giannoudis, P.V. (eds) Damage Control Management in the Polytrauma Patient. Springer, New York, NY. https://doi.org/10.1007/978-0-387-89508-6_20

Download citation

  • DOI: https://doi.org/10.1007/978-0-387-89508-6_20

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-89507-9

  • Online ISBN: 978-0-387-89508-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics