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. 2003 Apr;46(2):124-8.

Fracture fixation in patients having multiple injuries

Peter J O'Brien  1
Affiliations

Fracture fixation in patients having multiple injuries

Peter J O'Brien. Can J Surg. 2003 Apr.

Abstract
in English, French

The concept of early surgical stabilization of long-bone fractures in patients with multiple injuries became firmly established in the 1970s and 1980s. During the 1990s questions were raised about the early total care of all long-bone fractures in these patients. In particular, it was pointed out that patients with severe chest injuries and those with severe head injuries require special consideration. Although patients in those circumstances do require careful attention, most of the literature suggests that continued early surgical stabilization of these fractures, in particular femoral neck fractures, is important for patients who suffer polytrauma. The concept of early temporary surgical stabilization (damage control orthopedic surgery) has recently been suggested. In the majority of cases, femoral shaft fractures can be treated with interlocked intramedullary nailing.

Le concept de la stabilisation chirurgicale rapide des fractures des os longs chez les patients présentant de multiples blessures a été fermement établi dans les années 1970 et 1980. Au cours des années 1990, on a soulevé des questions relativement aux soins intégraux rapides de toutes les fractures des os longs chez ces patients. Plus particulièrement, on a fait remarquer que les patients atteints de graves blessures au thorax ou à la tête doivent faire l'objet d'une attention spéciale. Or, même s'il est vrai qu'il faut accorder une attention particulière aux patients dans cette situation, la plupart des écrits indiquent que la stabilisation chirurgicale rapide et continue de ces fractures est importante chez les polytraumatisés, surtout dans les cas de fracture du col du fémur. On a proposé le concept de la stabilisation chirurgicale temporaire rapide (chirurgie orthopédique pour limiter les dégâts). Dans la plupart des cas, l'enclouage centromédullaire avec verrouillage permet de traiter les fractures de la diaphyse fémorale.

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