Team Approach: Timing of Operative Intervention in Multiply-Injured Patients.

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* Patients with multiple-system trauma are best managed by a multidisciplinary team.* The general trauma surgeon is the leader of the care team, facilitating expeditious evaluation, resuscitation, and other treatment.* Early Appropriate Care is the definitive treatment of mechanically unstable fractures of the thoracolumbar spine, pelvis, acetabulum, and proximal and diaphyseal regions of the femur once the patient is adequately resuscitated as indicated by improvement of metabolic acidosis (at least 1 of the following findings: lactate <4.0 mmol/L, pH ≥7.25, or base excess ≥−5.5 mmol/L).* Early definitive stabilization of major axial and femoral fractures reduces complications, the duration of the hospital stay, and costs.