[Orthopedic surgical aspects of damage control surgery]

Damage control orthopedics (DCO) is a concept for treatment of fractures in severely injured patients. The fractures are stabilized with external fixators instead of primary definitive osteosynthesis, known as early total care (ETC). The purpose of DCO is to minimize time of surgery and bleeding and thereby minimize the "second hit". Not all patients require DCO, patients with stable vital functions can safely be treated with primary definitive osteosynthesis, DCO is, however, a safe method that can be used, when shorter time of surgery is desirable or a systemic immune response is imminent.