Nailed It Ortho Trauma Citation Classics 01- Damage Control Orthopaedics
Mar 6, 2022
Join Matthew Brown, a PGY-2 resident at Duke University Medical Center, along with Olumide Olotu, Nicholas Todd, and Brie Paradis from various medical institutions as they dive into the world of Damage Control Orthopaedics. They discuss the historical shift from total care to damage control in trauma management, emphasizing the critical timing in femur fracture stabilization. The team also unpacks the inflammatory responses during trauma, patient evaluation for surgery, and strategies to optimize recovery through timely interventions.
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Early Femur Fixation Benefits
- Early stabilization of femur fractures within 24 hours significantly lowers pulmonary complications and hospital stays compared to delayed fixation beyond 48 hours.
- Early total care reduces mortality risks by preventing fat embolism and ARDS in trauma patients with long bone fractures.
Delay Fixation to Reduce Mortality
- Fixing femoral shaft fractures too early (within 12 hours) in multi-trauma patients increases mortality risks significantly.
- Delaying fixation beyond 12 hours cuts mortality by half, especially with serious abdominal injuries.
Surgery as a Second Hit
- Major trauma primes the immune system, making surgical fixation a risky second hit that can trigger ARDS or organ failure.
- Surgery releases pro-inflammatory mediators and primes neutrophils, elevating complications in severely injured patients.