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The Poly-Traumatized Patient with Fractures pp 407–418Cite as

Outcome After Extremity Injuries

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Abstract

Well-designed clinical research remains necessary in order to evaluate the quality of care in trauma patients with lower extremity fractures. A critical assessment of the orthopaedic trauma outcome literature requires a critical review of the study validity, numerical results, and the actual implications for the clinical practice. This chapter summarizes the pertinent outcomes in polytrauma patients with extremity fractures. Over the last decades, improvements in the field of emergency and intensive care have decreased the mortality rates of polytrauma patients. With increased survival rates of polytrauma patients, the long-term functional outcomes have gained importance. Recent studies have shown that lower extremity fracture seems to significantly impact the functional recovery of polytrauma patients. In particular, distal lower extremity fracture, such as fractures below the knee joint, seems to be associated with significant long-term disability. With regard to mangled lower extremities, it remains unclear which particular subset of patients may benefit from limb salvage versus amputation. Recent research has emphasized that certain patient factors, such as patient self-efficacy, age, race, education level, smoking, pre-injury employment, and litigations, seem to have a significant impact on the patient recovery regardless of the treatment rendered. With regard to upper extremity injuries in polytrauma patients, the literature is limited. Clinical outcome studies have shown that in particular nerve injuries to the upper extremity, such as brachial plexus injuries, seem to limit the functional recovery.

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Authors and Affiliations

  1. Division of Orthopaedic Trauma, Department of Orthopaedic Surgery, University of Texas Health Science Center at San Antonio, Floyd Curl Dr, MC 7774, San Antonio, TX, 78229, USA

    Boris A. Zelle MD

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  1. Boris A. Zelle MD
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Correspondence to Boris A. Zelle MD .

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Editors and Affiliations

  1. Department of Trauma, Hand, Plastic and Reconstructive Surgery, Aachen Medical Center, Aachen, Germany

    Hans-Christoph Pape

  2. Florida Orthopaedic Institute, Temple Terrace, Florida, USA

    Roy Sanders

  3. Orthopedic Medicine Specialists, Arlington, Texas, USA

    Joseph Borrelli, Jr.

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Zelle, B.A. (2016). Outcome After Extremity Injuries. In: Pape, HC., Sanders, R., Borrelli, Jr., J. (eds) The Poly-Traumatized Patient with Fractures. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-47212-5_29

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  • DOI: https://doi.org/10.1007/978-3-662-47212-5_29

  • Publisher Name: Springer, Berlin, Heidelberg

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