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Review
. 2013 Mar 21:2013:329452.
doi: 10.1155/2013/329452. eCollection 2013.

Early Total Care versus Damage Control: Current Concepts in the Orthopedic Care of Polytrauma Patients

Ratto Nicola  1
Affiliations
Review

Early Total Care versus Damage Control: Current Concepts in the Orthopedic Care of Polytrauma Patients

Ratto Nicola. ISRN Orthop. .

Abstract

The management of the polytraumatized orthopedic patient remains a challenging issue. In recent years many efforts have been made to develop rescue techniques and to promote guidelines for the management of these patients. Currently controversies persist between two orthopedic approaches: the Early Total Care and the Damage Control Orthopedics. An overview of the current literature on the orthopedic management of polytrauma patient is provided. Subsequently, femoral shaft fractures, representing extremely common lesions, and pelvic ring injuries, that are associated with a high mortality rate, are analyzed in detail.

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Figures

Figure 1
Figure 1
Algorithm representing the management of the pelvic fracture in polytrauma patient. Abbreviations: EFAST: extended focused assessment sonography for trauma; CT Scan: computerized tomography; Ex-Fix: external fixation.
Figure 2
Figure 2
The algorithm for treatment of major fractures, based on patient's clinical categories (data from [26]). Abbreviations: OR: operating room; ICU: intensive care unit; ETC: early total care; DCO: damage control orthopedic; ABG: arterial blood gas; SBP: systolic blood pressure; EFAST: focused assessment with sonography in trauma; UO: urine output.
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