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When is the best time to fix fractures?

SpR Trauma & Orthopaedics, West Midlands, UK

KM Porter

Consultant Trauma & Orthopaedic Surgeon, Selly Oak Hospital, Birmingham, UK

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.

Key Words: resuscitation • fracture fixation • trauma • multiple injury

Trauma, Vol. 4, No. 3, 159-167 (2002)
DOI: 10.1191/1460408602ta230oa


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