When is the best time to fix fractures?

Abstract

The best time to operate on a fracture is governed in part by the nature of the fracture itself. It is also influenced by the premorbid condition of the patient and by the degree that associated injuries have disrupted normal processes. It is likely that some patients have a period of increased physiological risk for intervention, during which a second insult will result in further harm. The picture is not yet fully clear but relates to variations in the inflammatory response to trauma. One consistent lesson appears to resonate throughout the published literature. The most predictable risk factor for iatrogenic physiological disturbance is transfer to the operating theatre before adequate resuscitation of the patient has taken place.

Keywords

resuscitation fracture fixation trauma multiple injury

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References

Behrman SW , Fabian TC , Kudsk KA et al. 1990. J Trauma-Injury Infect Crit Care 30: 792-797; discussion 797-98.

Bone LB , Johnson KD , Weigelt J et al. 1989. J Bone Joint Surg 71: 336-340.

Broadie TA. 1981. Ann Emerg Med 10: 127-127.

Brundage SI , McGhan R , Jurkovich G et al. 2002.J Trauma-Injury Infect Crit Care 52: 299-307.

Bulger EM , Smith DG , Maier RV et al. 1997.Arch Surg 132: 435-439.

Burke M , Callum K , Gray A et al. 2001.The 2001 Report of the National Confidential Enquiry into Perioperative Deaths. Royal College of Surgeons.

Charash WE , Fabian TC , Croce MA. 1994.J Trauma-Injury Infect Crit Care 37: 667-672.

Christian C. 1998. In: Canale S ed.Campbell’s Operative Orthopaedics, 9th edition. St. Louis, MO: Mosby.

Dabezies EJ , D’Ambrosia R. 1986.Instructional Course Lectures 35: 13-21.

10.

Di Padova F , Durig M , Di Padova C et al. 1988.Surgery 103: 547-552.

11.

Dunham CM , Bosse MJ , Clancy TV et al. and the E. P. M. G. W. G. 2001.J Trauma-Injury Infect Crit Care 50: 958-967.

12.

Dwenger A , Remmers D , Grotz M et al. 1996.Eur J Clin Chem Clin Biochem 34: 207-214.

13.

Gando S , Nanzaki S , Morimoto V et al. 1999.J Trauma-Injury Infect Crit Care 47: 719-723.

14.

Ganong W. 1993. In: Review of Medical Physiology. East Norwalk, Conneticut: Appleton and Lange, p. 221-221.

15.

Gentilello LM , Jurkovich GJ , Stark MS et al. 1997.Ann Surg 226: 439-447; discussion 447-49.

16.

Giannoudis PV , Veysi VT , Pape HC et al. 2002.Am J Surg 183: 261-267.

17.

Gitin T , Seidel T , Cera P et al. 1993. Crit Care Med 21: 673-677.

18.

Gossling HR , Pellegrini VD, Jr. 1982. Clin Orthop Relat Res 68-82.

19.

Gregory JS , Flancbaum L , Townsend MC et al. 1991.J Trauma-Injury Infect Crit Care 31: 795-798; discussion 798-800.

20.

Gunning KA , Sugrue M , Sloane D et al. 1995. Austral NZ J Surg 65: 80-82.

21.

Gurd AR. 1970.J Bone Joint Surg 52: 732-737.

22.

Gustilo RB , Anderson JT. 1976. J Bone Joint Surg 58: 453-458.

23.

Gustilo RB , Merkow RL , Templeman D. 1990.J Bone Joint Surg 72: 299-304.

24.

Han DC , Rozycki GS , Schmidt JA et al. 1996.Trauma-Injury Infect Crit Care 41: 208-213.

25.

HofmanPA , Goris RJ. 1991. J Trauma-Injury Infect Crit Care 31: 261-263.

26.

Jaicks RR , Cohn SM , Moller BA. 1997.J Trauma-Injury Infect Crit Care 42: 1-5; discussion 5-6.

27.

James LA , Sookhan N , Subar D. 2001.Injury 32: 469-472.

28.

Johnson KD , Cadambi A , Seibert GB. 1985.J Trauma-Injury Infect Crit Care 25: 375-384.

29.

Jurkovich GJ , Greiser WB , Luterman A et al. 1987.J Trauma-Injury Infect Crit Care 27: 1019-1024.

30.

Kettelkamp DB , Alexander H. 1967.J Trauma-Injury Infect Crit Care 7: 424-432.

31.

Kutscha-Lissberg F , Hopf FK , Kollig E et al. 2001.Injury 32: 289-293.

32.

LeQuire V. 1959. Am J Pathol 35: 999-999.

33.

Mammen EF , Wilson RF. 1996. In: Wilson RF , Walt AJ eds. Management of Trauma: Pitfalls and Practice. Williams and Wilkins, 1012-1040.

34.

Marinkovic S , Jahreis GP , Wong GG et al. 1989.J Immunol 142: 808-812.

35.

Mehlman CT , Strub WM , Roy DR , Wall EJ , Crawford AH. 2001. J Bone Joint Surg 83A: 323-327.

36.

Mollnes TE , Fosse E. 1994.Shock 2: 301-310.

37.

Moulton SL. 2000.Clinical Orthopaedics & Related Research, 6-14.

38.

Muller ME , Allgower M , Schneider R , Willenegger H. 1991. Manual of Internal fixation: Techniques recommended by the AO-ASIF Group. Springer Verlag.

39.

Napolitano LM , Ferrer T , McCarter RJ, Jr et al. 2000.J Trauma-Injury Infect Crit Care 49: 647-652; discussion 652-53.

40.

Nowotarski PJ , Turen CH , Brumback RJ et al. 2000.J Bone Joint Surg 82: 781-788.

41.

Ohnishi M , Kirkman E , Hiraide A et al. 1998.J Trauma-Injury Infect Crit Care 45: 1024-1030.

42.

Pape HC , Dwenger A , Regel G et al. 1994a. Br J Surg 81: 850-852.

43.

Pape HC , Regel G , DwengerA et al. 1993. J Trauma-Injury Infect Crit Care 35: 709-716.

44.

Pape HC , Remmers D , Grotz M et al. 1999a. Arch Surg 134: 421-447.

45.

Pape HC , Remmers D , Grotz M et al. 1999b. J Trauma-Injury Infect Crit Care 46: 907-913.

46.

Pape HC , Remmers D , Kleeman W et al. 1994b. Shock 2: 228-234.

47.

Pape HC , Remmers D , Rice J et al. 2000a. J Trauma-Injury Infect Crit Care 49: 496-504.

48.

Pape HC , Schmidt RE , Rice J et al. 2000b. Crit Care Med 28: 3441-3448.

49.

Pape HC , van Griensven M , Rice J et al. 2001. J Trauma-Injury Infect Crit Care 50: 989-1000.

50.

Patt A , McCroskey BL , Moore EE. 1988. Surg Clin North America 68: 775-785.

51.

Perez JV , Warwick DJ , Case CP et al. 1995. Injury 26: 237-240.

52.

Poole GV , Miller JD , Angew SG et al. 1992. J Trauma-Injury Infect Crit Care 32: 654-659.

53.

Remmers D , Dwenger A , Grotz M et al. 1996.J Surg Res 62: 278-283.

54.

Reynolds MA , Richardson JD , Spain DA et al. 1995.Ann Surg 222: 470-478; discussion 478-81.

55.

Riska EB , von Bonsdorff H , Hakkinen S et al. 1977.J Trauma-Injury Infect Crit Care 17: 111-121.

56.

Robinson CM. 2001.J Bone Joint Surg 83: 781-791.

57.

Rockwood C , Green D , Bucholz R , Heckman J. (eds) 1996. Rockwood and Green’s Fractures in Adults. Philadelphia: Lippincott-Raven.

58.

Rogers FB , Shackford SR , Keller MS. 1995.J Trauma-Injury Infect Crit Care 39: 261-265.

59.

Rogers FB , Shackford SR , Vane DW et al. 1994.J Trauma-Injury Infect Crit Care 36: 774-777.

60.

Rothenberger D , Velasco R , Strate R et al. 1978.J Trauma-Injury Infect Crit Care 18: 184-187.

61.

Rutherford EJ , Fusco MA , Nunn CR et al. 1998.Injury 29: 605-608.

62.

Scalea TM , Boswell SA , Scott JD et al. 2000.J Trauma-Injury Infect Crit Care 48: 613-621; discussion 621-23.

63.

Scalea TM , Rodriguez A , Chiu WC et al. 1999a.J Trauma-Injury Infect Crit Care 46: 466-472.

64.

Scalea TM , Scott JD , Brumback RJ et al. 1999b.J Trauma-Injury Infect Crit Care 46: 839-846.

65.

Schemitsch EH , Turchin DC , Anderson GI et al. 1998.J Trauma-Injury Infect Crit Care 45: 738-742.

66.

Shackford SR , Rogers FB , Osler TM et al. 1999.J Trauma-Injury Infect Crit Care 46: 553-562; discussion 562-64.

67.

Steinemann S , Shackford SR , Davis JW. 1990.J Trauma-Injury Infect Crit Care 30: 200-202.

68.

Swiontkowski M. 1996. In: Heckman J ed. Rockwood and Green’s Fractures in Adults. Philadelphia: Lippincott-Raven, pp. 121-157.

69.

Tisherman SA , Rodriguez A , Safar P. 1999.Surg Clin North America 79: 1269-1289.

70.

Tornetta P , Mostafavi H , Riina J et al. 1999.J Trauma-Injury Infect Crit Care 46: 702-706.

71.

Townsend RN , Lheureau T , Protech J et al. 1998.J Trauma-Injury Infect Crit Care 44: 977-982; discussion 982-83.

72.

Trunkey DD , Chapman MW , Lim RC et al. 1974.J Trauma-Injury Infect Crit Care 14: 912-923.

73.

Varela CD , Vaughan TK , Carr JB , SlemmonsBK . 1993.J Orthop Trauma 7: 417-427.

74.

Velmahos GC , Arroyo H , Ramicone E et al. 1998.Am J Surg 176: 324-326; discussion 329-30.

75.

Watts DD , Trask A , Soeken K et al. 1998.J Trauma-Injury Infect Crit Care 44: 846-854.

76.

Waydhas C , Nast-Kolb D , Trupka A et al. 1996.J Trauma-Injury Infect Crit Care 40: 624-630; discussion 630-31.

77.

Ziran BH , Le T , Zhou H et al. 1997.J Trauma-Injury Infect Crit Care 43: 916-921.

78.

Zuckerman J , Koval KJ. 1996. In: Heckman J ed. Rockwood and Green’s Fractures in Adults. Philadelphia: Lippincott-Raven, pp. 1043-1044.