When should we operate on major fractures in patients with severe head injuries?

Abstract

BACKGROUND:

The widely accepted practice of early fracture fixation (EFF) in multiply injured patients has recently been challenged in the presence of head injury.

DATA SOURCES:

English and German language articles on the subject were searched using Medline. Keywords included head trauma, intracranial trauma, brain injuries, fractures, fracture fixation, timing, femur fracture, and tibia fracture.

CONCLUSIONS:

The available literature does not provide clear-cut guidance on the management of fractures in the presence of head injuries. The trend is toward a better outcome if the fractures are fixed early. Treatment should therefore be tailored to the individual patient, with the assumption that full neurologic recovery will take place.

• Authors: Peter V Giannoudis, Veysi T Veysi, Hans-Christoph Pape, Cristian Krettek, Malcolm R Smith
• Journal: American journal of surgery (Am J Surg) Vol. 183 Issue 3 Pg. 261-7 (Mar 2002) ISSN: 0002-9610 [Print] United States
• PMID: 11943123 (Publication Type: Comparative Study, Journal Article, Review)

Topics

• Craniocerebral Trauma (complications, diagnosis, mortality)
• Female
• Femoral Fractures (complications, mortality, surgery)
• Fracture Fixation, Internal (adverse effects, methods)
• Germany
• Humans
• Injury Severity Score
• Male
• Multiple Trauma (diagnosis, mortality, surgery)
• Practice Guidelines as Topic
• Prognosis
• Risk Assessment
• Sensitivity and Specificity
• Survival Rate
• Tibial Fractures (complications, mortality, surgery)
• Time Factors
• Triage