(i) Assessment—principles and management of major trauma beyond ATLS®

Abstract

Fractures are frequently associated with polytraumatized patients and must be considered as wounds of bone and soft tissue which create stress, pain and haemorrhage. Fractures can be contaminated. They may cause compartment syndromes with ischaemia-reperfusion injury. The unstable skeleton enforces immobility and may not permit optimal positioning of those patients for intensive care with chest and brain injuries.