[Early osteosynthesis of fractures of the lower extremities in patients with multiple trauma]

In the early 1970s, some trauma centres began to perform early operative fixation of lower limb fractures in multiple trauma patients. At that time, no clinical studies were available on this topic. At present, several publications have demonstrated lower mortality, reduction of the incidence of Adult Respiratory Distress Syndrome and sepsis, and a shorter stay in hospital after early operative fracture fixation compared with conservative fracture management or late fracture fixation. The incidence of fracture complications appeared not to increase after early operative fracture fixation. The present paper is a review of the most significant reports concerning timing of operative fracture management of patients with multiple trauma. Prospective randomised trials are needed on this subject.