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Review
. 2024 Apr 19:11:1362986.
doi: 10.3389/fmed.2024.1362986. eCollection 2024.

Fracture fixation in polytraumatized patients-From an interdisciplinary early total/appropriate care to the safe definitive surgery concept

Yannik Kalbas  1 , Sandro-Michael Heining  1 , Anne Kaiser  2 , Felix Karl-Ludwig Klingebiel  1 , Roman Pfeifer  1 , Guido A Wanner  3 , Hans-Christoph Pape  1
Affiliations
Review

Fracture fixation in polytraumatized patients-From an interdisciplinary early total/appropriate care to the safe definitive surgery concept

Yannik Kalbas et al. Front Med (Lausanne). .

Abstract

The strategies for the timing of fracture fixation in polytrauma patients have changed with improvements in resuscitation and patient assessment. Specifically, the criteria for damage control have been formulated, and more precise parameters have been found to determine those patients who can safely undergo primary definitive fixation of major fractures. Our current recommendations are supported by objective and data-based criteria and development groups. Those were validated and compared to existing scores. This review article introduces the concept of "safe definitive surgery" and provides an update on the parameters used to clear patients for timely fixation of major fractures.

Keywords: borderline patient; fracture management; multiply injured patients; polytrauma; safe definitive surgery.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Decision-making in Polytrauma patients should be based on the initial assessment of the patient physiology and on the response to resuscitative measures. DCS, damage control surgery; ICU, intensive care unit [modified from Pape et al. (8)].
See this image and copyright information in PMC

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