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Damage-Control Orthopaedic Surgery in Polytrauma: Influence on the Clinical Course and Its Pathogenetic Background

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European Instructional Lectures

The standard of care for major extremity fractures in patients with multiple injuries foresees early defi nitive fi xation of all major fractures. Recently controversial results were gathered from studies [1-7], and observations were made about certain patient sub-groups that developed unexpectedly high complication rates, when early definitive stabilization was performed. It was suggested that potential deleterious effects of internally fi xing long-bone fractures in the acute setting, where systemic hypo-perfusion and inflammation occurred, increases susceptibility to end-organ injury. In summary, three factors appeared to play a role that are pathogenetically connected:

  1. 1.

    Additional severe injuries (such as chest trauma)

  2. 2.

    Prolonged surgeries

  3. 3.

    The pre-operative condition [8, 9]

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Author information

Authors and Affiliations

  1. Department of Orthopaedics, University of Aachen, Chairman, Pauwelstreet 30, Aachen, 52074, Germany

    Hans-Christoph Pape

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  1. Hans-Christoph Pape
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Editors and Affiliations

  1. Royal National Orthopaedic Hospital Trust, Stanmore, Middlesex, HA 7 4LP, UK

    George Bentley

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Pape, HC. (2009). Damage-Control Orthopaedic Surgery in Polytrauma: Influence on the Clinical Course and Its Pathogenetic Background. In: Bentley, G. (eds) European Instructional Lectures. European Federation of National Associations of Orthopaedics and Traumatology, vol 9. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-00966-2_8

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  • DOI: https://doi.org/10.1007/978-3-642-00966-2_8

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