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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2017

Open Access 01-12-2017 | Research article

Damage control surgery – experiences from a level I trauma center

Authors: Bernhard Gasser, Thomas M. Tiefenboeck, Sandra Boesmueller, Danijel Kivaranovic, Adam Bukaty, Patrick Platzer

Published in: BMC Musculoskeletal Disorders | Issue 1/2017

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Abstract

Background

There is still no evidence in literature for damage control orthopaedics (DCO), early total care (ETC) or using external fixation solely in fractures of the long bones in multi-system-trauma. The aim of this study was to determine parameters influencing the choice of treatment in clinical routine (DCO, ETC, or EF) in femoral or tibial shaft fractures in combination with multi-system-trauma, severe soft tissue damage or both.

Methods

Data of 236 patients with 280 fractures of long bones of the lower extremities treated at a level I trauma center were analysed. Clinical parameters on arrival (age, sex [m/f], ISS, fracture site [femur/tibia], soft tissue damage [closed or open fractures according to the Gustilo-Anderson classification], pulmonary injury [yes/no]) were collected and analysed whether they influence the choice of upcoming treatment (DCO/ETC/EF).

Results

Our findings showed that high ISS and severe soft tissue damage (grade III) significantly correlated with DCO. High ISS, old age, female sex and fracture site (tibia) correlated with EF. This group of sole use of external fixation had highest rate of complications, 69% were associated with at least one complication.

Conclusion

Severely injured patients are treated significantly more often with DCO or EF. The presence of higher ISS (≥16) and of type III open fractures increased the use of DCO. However, ISS, fracture-site, patient’s age, type III open fractures or sex (female) increased the use of EF compared to ETC.
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Metadata
Title
Damage control surgery – experiences from a level I trauma center
Authors
Bernhard Gasser
Thomas M. Tiefenboeck
Sandra Boesmueller
Danijel Kivaranovic
Adam Bukaty
Patrick Platzer
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2017
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-017-1751-6

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