Surgical timing of treating injured extremities

an evolving concept of urgency.

Brett D. Crist, Tania Ferguson, Yvonne M. Murtha, Mark A Lee

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

The management of some orthopaedic extremity injuries has changed over the past decade because of changing resource availability and the risks of complications. It is helpful to review the current literature regarding orthopaedic extremity emergencies and urgencies. The effects of the techniques of damage control orthopaedic techniques and the concept of the orthopaedic trauma room have also affected the management of these injuries. The available literature indicates that the remaining true orthopaedic extremity emergencies include compartment syndrome and vascular injuries associated with fractures and dislocations. Orthopaedic urgencies include open fracture management, femoral neck fractures in young patients treated with open reduction and internal fixation, and talus fractures that are open or those with impending skin compromise. Deciding when the definitive management of orthopaedic extremity injuries will occur has evolved as the concept of damage control orthopaedics has become more commonly accepted. Patient survival rates have improved with current resuscitative protocols. Definitive fixation of extremity injuries should be delayed until the patient's physiologic and extremity soft-tissue status allows for appropriate definitive management while minimizing the risks of complications. In patients with semiurgent orthopaedic injuries, the use of an orthopaedic trauma room has led to more efficient care of patients, fewer complications, and better time management for surgeons who perform on-call service for patients with traumatic orthopaedic injuries.

Original languageEnglish (US)
Pages (from-to)17-28
Number of pages12
JournalInstructional course lectures
Volume62
StatePublished - 2013

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Orthopedics
Extremities
Wounds and Injuries
Emergencies
Internal Fracture Fixation
Time Management
Compartment Syndromes
Talus
Femoral Neck Fractures
Open Fractures
Vascular System Injuries
Patient Care
Survival Rate
Skin

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Surgical timing of treating injured extremities : an evolving concept of urgency. / Crist, Brett D.; Ferguson, Tania; Murtha, Yvonne M.; Lee, Mark A.

In: Instructional course lectures, Vol. 62, 2013, p. 17-28.

Research output: Contribution to journalArticle

Crist, Brett D. ; Ferguson, Tania ; Murtha, Yvonne M. ; Lee, Mark A. / Surgical timing of treating injured extremities : an evolving concept of urgency. In: Instructional course lectures. 2013 ; Vol. 62. pp. 17-28.
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