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European Journal of Trauma and Emergency Surgery

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Open Access 15-02-2021 | Femoral Fracture | Original Article

Strategies for the treatment of femoral fractures in severely injured patients: trends in over two decades from the TraumaRegister DGU^®

Authors: Felix M. Bläsius, Markus Laubach, Hagen Andruszkow, Philipp Lichte, Hans-Christoph Pape, Rolf Lefering, Klemens Horst, Frank Hildebrand, Trauma Register DGU®

Published in: European Journal of Trauma and Emergency Surgery | Issue 3/2022

Abstract

Purpose

Treatment strategies for femoral fracture stabilisation are well known to have a significant impact on the patient’s outcome. Therefore, the optimal choices for both the type of initial fracture stabilisation (external fixation/EF, early total care/ETC, conservative treatment/TC) and the best time point for conversion from temporary to definitive fixation are challenging factors.

Patients

Patients aged ≥ 16 years with moderate and severe trauma documented in the TraumaRegister DGU^® between 2002 and 2018 were retrospectively analysed. Demographics, ISS, surgical treatment strategy (ETC vs. EF vs. TC), time for conversion to definitive care, complication (MOF, sepsis) and survival rates were analysed.

Results

In total, 13,091 trauma patients were included. EF patients more often sustained high-energy trauma (car: 43.1 vs. 29.5%, p < 0.001), were younger (40.6 vs. 48.1 years, p < 0.001), were more severely injured (ISS 25.4 vs. 19.1 pts., p < 0.001), and had higher sepsis (11.8 vs. 5.4%, p < 0.001) and MOF rates (33.1 vs. 16.0%, p < 0.001) compared to ETC patients. A shift from ETC to EF was observed. The time until conversion decreased for femoral fractures from 9 to 8 days within the observation period. Sepsis incidences decreased in EF (20.3 to 12.3%, p < 0.001) and ETC (9.1–4.8%, p < 0.001) patients.

Conclusions

Our results show the changes in the surgical treatment of severely injured patients with femur fractures over a period of almost two decades caused by the introduction of modern surgical strategies (e.g., Safe Definitive Surgery). It remains unclear which subgroups of trauma patients benefit most from these strategies.

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Title: Strategies for the treatment of femoral fractures in severely injured patients: trends in over two decades from the TraumaRegister DGU®
Authors: Felix M. Bläsius
Markus Laubach
Hagen Andruszkow
Philipp Lichte
Hans-Christoph Pape
Rolf Lefering
Klemens Horst
Frank Hildebrand
Trauma Register DGU®
Publication date: 15-02-2021
Publisher: Springer Berlin Heidelberg
Keywords: Femoral Fracture
Septicemia
Septicemia
Care
External Fixator
Published in: European Journal of Trauma and Emergency Surgery / Issue 3/2022
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-020-01599-4

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Strategies for the treatment of femoral fractures in severely injured patients: trends in over two decades from the TraumaRegister DGU^®

Abstract

Purpose

Patients

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Patients

Results

Conclusions

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