2008, Number 1
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Acta Ortop Mex 2008; 22 (1)
Damage control in long bones and pelvis in the Mexican Red Cross Trauma Center
Vázquez VAD, Bello GA, Caballero QEA
Language: Spanish
References: 24
Page: 45-49
PDF size: 135.78 Kb.
ABSTRACT
Multiple injured patients account for some of the biggest and most complex problems a trauma surgeon has to face in his daily routine; thus, applying orthopedic damage control (DCO) is important. Multiple injured patients treated at the Medical Red Cross Medical Trauma Center were reviewed, in the period comprised between June 2006 and July 2007. One-hundred cases with long bone and pelvis fractures, ranging between 10 and 75 years old, 21 women (21%) and 79 men (79%); the most common trauma mechanism was patients falling from a height above 2 meters (33%). The most frequently affected bone was the femur with 43 fractures AO32B. The most common open fracture was that of the tibia the (18 IIIB AO 42B). Six amputations were carried out, most commonly CDO used was external fixation (44), cases of fat embolism (2) deceased (3). The results were satisfactory with the usage of DCO.
REFERENCES
Shapiro MB, Jenkins DH, Rotondo SW: Damage control: Collective. Review J Trauma 2000; 49: 969-78.
Pape HC, Giannoudis P, Krettek C: The timing of fracture treatment in polytrauma patients: relevance of damage control orthopedic surgery. Am J Surg 2002; 183: 622-9.
Rotondo MF, Schwab CW, McGonigal MD, et al: Damage control an approach for improved survival in exsanguinating penetrating abdominal injuries. J Trauma 1993; 35: 375-82.
Giannoudis PV: Aspects of current management: surgical priorities in damage control in polytrauma. J Bone Joint Surg 2003; 85-B: 478-83.
Pape HC, Tscherne H. Early definitive fracture fixation, pulmonary function and systemic effects. In: Baue AE, Faist E, Fry DE, eds. Multiple organ failure: Pathophysiology. Prevention, and therapy. New York: Springer-Verlag; 2000: 279-90.
Giannoudis PV, Smith RM, Bellamy MC: Stimulation of the inflammatory system by reamed and undreamed nailing of femoral fractures - an analysis of the second hit. J Bone Joint Surg Br 1999; 81: 356-61.
Winchell RJ, Hoyt DB, Walsh JC. Simons RK, et al: Risk factors associated with pulmonary embolism despite routine prophylaxis: implications for improved protection. J Trauma 1994; 37(4): 600-6.
Dunham CM, Bosse JM, Clancy VT, et al: Practice management guidelines for the optimal timing of long-bone fracture stabilization in polytrauma patients: The EAST practice management guidelines work group. J Trauma 2001; 50: 958-67.
Smith RM, Giannoudis PV. Trauma and the immune response. J R Soc Med 1998; 91: 417-20.
Ruedi TP, Murphy WM. AO Principles of fracture of management: Thieme Stuttgart. 2000; 45-8: 233-46.
Gustilo RB, Anderson JT: Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: Retrospective and prospective analysis. J Bone Joint Surg 58A: 453-8.
Helfet DL, Howey T, Sanders R, Johansen K: Limb salvage versus amputation. Preliminary results of the Mangled Extremity Severity Score. Clin Orthop 1990: 80-6.
Johnson KD, Cadambi A, Seibert B: Incidence of adult respiratory distress syndrome in patients with multiple musculoskeletal injuries: effect of early operative stabilization of fractures. J Trauma 1985; 25: 375-81.
Bone LB, Jonson KD, Weigelt J, et al: Early versus delayed stabilization of fractures. J Bone Join Surg Am 1989; 71: 336-9.
Fabian TC, Hoots AV, Stanfood AS et al. Fat embolism syndrome: prospective in 92 fracture patients. Crit Care Med 1990; 18(1): 42-6.
Arellano G, Herrera Z, Mondragon C: Protocolo de manejo integral del paciente polifracturado. Revisión epidemiológica. Rev Mex Ortop Traum 1999; 15(2): 369-400.
Nowotarski PJ, Turen CH, Brumback RJ, et al: Conversion of external fixation to intramedullary nailing for fractures of the shaft of the femur in multiply injured patients. J Bone Joint Surg Am 2000; 82: 781-8.
Nau T, Aldrian S, Koening F, et al: Fixation of femoral fractures in multiple injury patients with combined chest and head injuries. ANZ J Surg 2003; 73: 1018-21.
Pape HC, Grimme K, van Griensven M, et al: Impact of intramedullary instrumentation versus damage control for femoral fractures on immunoinflammatory parameters in a prospective randomized analysis. J Trauma 2003; 55: 1-7.
Carlson DA, Rodean GH, Caer D, et al. Femur fractures in chest injured patients: Is reaming contraindicated. J Orthop Trauma 1998; 12: 164-8.
Pelias ME, Townsend M, Flancbaum L. Long bone fractures predispose to pulmonary dysfunction in blunt chest trauma despite early operative fixation. Surgery 1992; 111: 576-9.
Eastridge BJ, Starr A, Minei JP, et al: The importance of fracture pattern in guiding therapeutic decision-making in patients with hemorrhagic shock and pelvic ring disruptions. J Trauma 2002; 53: 446-50.
Burri C, Henkemeyer H, Passler HH, et al: Evaluation of acute blood loss by means of simple hemodynamic parameter. Progr Surg 1973; 11: 109-27.
Wudel JH, Morris JA Jr, Yates K, et al: Massive transfusion outcome in blunt trauma patients. J Trauma 1991; 31: 1-7.