Application of damage control orthopedics in treatment of severe multiple injuries combined with fractures

Abstract

Objective To probe the feasibility, indications and efficacy of damage control orthopedics (DCO) in treating severe multiple injuries combined with fractures. Methods A retrospective analysis was done on the clinical data of 31 patients with severe multiple injuries combined with fractures treated by DCO from 1998 to 2008. Results Of all patients, 18 patients were combined with pelvic fractures and hemorrhage. Bilateralis hypogastric artery ligation was performed early in 17 patients and nonage pelvis external fixation was performed in 12. Eleven multiple trauma patients combined with femoral fractures received primary debridement and temporal external fixation for further definitive internal fixation. Two patients with spinal fractures combined with spinal cord compression received primary simple decompression. All patients received resuscitation in ICU for average 4.3 days (1-11 days). There was one death due to hemorrhagic shock. Conclusions DCO well conforms to pathophysiological character of the wounded. Early DCO and later integrated treatment are key to enhancement of the survival rate of the multiple trauma patients. Key words: Multiple trauma; Damage control orthopedics; Fractures