DAMAGE CONTROL IN ORTHOPEDICS

Abstract

Introduction: DAMAGE CONTROL - in orthopedic surgery and traumatology, it is indicated for fresh fractures, especially for trauma with open bone fractures. In all these fresh fractures, hemodynamic instability of the body occurs. In these cases, a minimally invasive procedure is recommended, which initially aims to temporarily stabilize the fractures and control bleeding Material and methods: In our work, we will present the official literature that deals with the issue of damage control in orthopedics. Discussion: One of the leading causes of death in people under 40 is polytrauma. Fractures of the diaphysis of the tibia, femur, and pelvis are the most common fractures that are stabilized using external fixation. Bilateral fractures of the femoral diaphysis are associated with a poor prognosis in terms of mortality and fat embolism syndrome.Hemodynamically stable patients should always undergo definitive fracture fixation. Any prolonged intervention in hemodynamically unstable patients worsens the favorable outcome. Then the immune response can be triggered and increased, which is identified with the clinical condition “Second trauma”. Therefore, these patients should be immediately subjected to DAMAGE CONTROL with temporary stabilization and then delayed definitive fixation for a period of 5-10 days from damage control, i.e. in the second act. Orthopedic surgeons should be very careful and recognize the triangle of death - acidosis, hypothermia and coagulopathy, which are interconnected and eventually become irreversible and lead to death as the final outcome. Damage control surgery in orthopedics includes three stages: the first stage of treatment involves controlling bleeding, reducing contamination, and achieving temporary fracture fixation. The time in which all this is done should be as short as 1-2 hours. The second phase involves the stabilization of vital parameters in the ICU as well as the reanimation of the child with the prescription of the necessary therapy as well as blood replacement The aim: The aim of our work is to demonstrate the outcome and feasibility of damage control in orthopedic surgery for both adults and children with multiple limb injuries and polytraumatized patients Conclusion: Polytrauma is a condition of the body that requires immediate action and a special approach because the patient’s life is at risk in a high percentage. The principles used to manage patients with multiple injuries including head, lower leg. Early fracture fixation led to earlier mobilization of patients and thus And reduced the percentage of complications, wound infections as well as reducing treatment costs. DAMAGE CONTROL is not only used in traumatized adult patients. It is also necessary to do it in children’s patients.