gms | German Medical Science

Deutscher Kongress für Orthopädie und Unfallchirurgie, 75. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 97. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie, 52. Tagung des Berufsverbandes der Fachärzte für Orthopädie und Unfallchirurgie

25. - 28.10.2011, Berlin

Article

Send article

The timing of definitive fixation for major fractures in polytrauma – a matched pair comparison between a US and European level I centers

Meeting Abstract

Search Medline for

  • K. Horst - Univ.-Klinikum der RWTH Aachen, Klinik für Orthopädie und Unfallchirurgie, Schwerpunkt Unfallchirurgie, Aachen, Germany
  • V. Schreiber - University of Pittsburgh, Department of Orthopaedic Surgery, Pittsburgh, USA
  • I. Tarkin - University of Pittsburgh, Department of Orthopaedic Surgery, Pittsburgh, USA
  • R. Pfeifer - Univ.-Klinikum der RWTH Aachen, Klinik für Orthopädie und Unfallchirurgie, Schwerpunkt Unfallchirurgie, Aachen, Germany
  • P. Giannoudis - University of Leeds, Academic Department of Trauma & Orthopaedics, Leeds, United Kingdom
  • H.-C. Pape - Univ.-Klinikum der RWTH Aachen, Klinik für Orthopädie und Unfallchirurgie, Schwerpunkt Unfallchirurgie, Aachen, Germany

Deutscher Kongress für Orthopädie und Unfallchirurgie. 75. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 97. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie, 52. Tagung des Berufsverbandes der Fachärzte für Orthopädie. Berlin, 25.-28.10.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocPO18-699

doi: 10.3205/11dkou657, urn:nbn:de:0183-11dkou6574

Published: October 18, 2011

© 2011 Horst et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Questionnaire: Early definitive stabilization is usually the treatment of choice for major fractures in polytrauma patients. Modifications may be made when patients are in critical condition, or when associated injuries dictate the timing of surgery. The current study investigates whether the timing of fructure treatment is different in different trauma systems.

Methods: Consecutive patients treated a Level I trauma center were documented (Group US) and a matched-pair group was gathered from the German Trauma Registry (Group GTR). Inclusion criteria: New Injury Severity Score (NISS) >16, >2 major fractures and >1 organ/soft tissue injury. The timing and type of surgery for major fractures was recorded, as were major complications.

Results and Conclusions: 114 patients were included, n=57 Group US (35.1% F, 64.9% M, mean age: 44.1 yrs ±16.49, mean NISS: 27.4±8.65, mean ICU stay: 10±7.49) and n=57 Group GTR (36.8% F, 63.1% M, mean age: 41.2 yrs ±15.35, mean NISS: 29.4±6.88, mean ICU stay: 15.6±18.25). 44 (57.1%) out of 77 fractures in Group US received primary definitive fracture fixation compared to 61 (65.5%) out of 93 fractures in Group GTR (n.s.). The average duration until definitive treatment was comparable in all major extremity fractures (pelvis: 5 days ±2.8 Group US, 7.1 days ±9.6 Group GTR (n.s.), femur: 7.9 days ±8.3 Group US, 5.5 days ±7.9 (n.s.), tibia: 6.2 days ±5.6 Group US, 6.2 days ±9.1 Group GTR (n.s.), humerus: 5 days ±3.7 Group US, 6.6 days ±6.1 Group GTR (n.s.), radius: 6 days ±4.7 Group US, 6.1 days ±8.7 Group GTR (n.s.)). The current matched pair analysis demonstrates that the timing of initial definitive fixation of major fractures is comparable between the US and Europe. Certain fractures are stabilized internally in a staged fashion regardless the trauma system, thus discounting previous apparent contradictions.