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Pathophysiology of Polytrauma

  • Chapter
The Poly-Traumatized Patient with Fractures

Abstract

The pathophysiology of the polytraumatized patient is a complex phenomenon aiming to restoration of homeostasis and preservation of life. The initial response to major trauma is dominated by the effort to control the hemorrhagic shock. During the subsequent phase of the immune system activation (systemic inflammatory response syndrome (SIRS) and counter anti-inflammatory response syndrome (CARS)) the organism is trying to restore the physiologic equilibrium. Depending on the characteristics of the initial trauma (first hit) and the impact of actions and interventions that follow (second hit(s)) patients may either recover or develop complications. In cases where the patient is physiologically unstable, our clinical decisions should be governed by the principle of damage control orthopedics (DCO) in order to minimize the sequelae of the second hit insult. Accordingly, reliable clinical evaluation of the physiologic status of the patient and immunomonitoring are of paramount importance.

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Authors and Affiliations

  1. Trauma and Orthopaedic Surgery, Leeds General Infirmary, A Floor Clarendon Wing, Leeds General Infirmary, Great George Street, Leeds, LS1 3EX, UK

    Theodoros Tosounidis MD & Peter V. Giannoudis MD, FRCS

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  1. Theodoros Tosounidis MD
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  2. Peter V. Giannoudis MD, FRCS
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Correspondence to Theodoros Tosounidis 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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Tosounidis, T., Giannoudis, P.V. (2016). Pathophysiology of Polytrauma. 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_5

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