External Fixators as a Tool for Damage Control Orthopedics in Severely Injured or Polytrauma Patients

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Emergency Medicine

Background:

• Polytrauma patients require specialized emergency surgical management.
• Damage control surgery is a strategy for critically injured patients.
• The role of damage control in orthopedic polytrauma needs further exploration.

Purpose of the Study:

• To explore the use and effectiveness of damage control techniques in polytrauma patients with orthopedic injuries.
• To evaluate the safety and impact of damage control surgery on patient recovery.
• To determine the criteria for selecting damage control versus definitive surgical management.

Main Methods:

• Retrospective review of medical records from 2021-2024.
• Analysis of 29 polytrauma patients requiring surgical intervention.
• Utilized Injury Severity Score (ISS) to guide treatment decisions.

Main Results:

• 13 patients (ISS > 9) were managed with damage control techniques, primarily external osteosynthesis (ExFix).
• External fixation effectively stabilized fractures and controlled bleeding in patients with multiple orthopedic injuries.
• Damage control surgery facilitated resuscitation and recovery, and in 3 cases, served as definitive treatment.

Conclusions:

• Damage control surgery, particularly external fixation for long bone fractures, is safe and beneficial for polytrauma patients with ISS > 9.
• This approach is effective for fracture stabilization and hemorrhage control in severe orthopedic trauma.
• Damage control surgery can be a valuable component of polytrauma management, improving patient outcomes.