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Objetivo y método
En este trabajo se revisa el conocimiento adquirido a partir de los principales artículos publicados en los últimos treinta años, acerca del mejor momento para el tratamiento quirúrgico y de los métodos de fijación a emplear en las fracturas de los huesos largos en el politraumatizado, con el fin de mejorar los resultados en cuanto a la morbimortalidad global de estos pacientes.
ConclusionesLos estudios revisados ponen de manifiesto la necesidad de aplicar protocolos de «tratamiento precoz definitivo» (early total care) y «cirugía ortopédica de control de daños» (damage control orthopaedic surgery), intentando estabilizar las fracturas en las primeras 24 horas para limitar la respuesta inflamatoria sistémica y permitir un control respiratorio adecuado de estos pacientes, disminuyendo así las cifras de morbimortalidad y los costes de la atención sanitaria.
Palabras clave:
traumatismo múltiple
politraumatizado
respuesta inflamatoria sistémica
fracturas huesos largos
traumatismo de alta energía
Aim and methods
We reviewed the principal articles published over the last 30 years regarding the best moment for surgical treatment and fixation methods for long bone fracture of patients with multiple injuries to optimize results in terms of overall morbidity and mortality in these patients.
ConclusionsThe literature confirmed the need for early total care and damage control orthopedic surgery protocols. An attempt should be made to stabilize fractures in the first 24 hours to limit the systemic inflammatory response and improve the respiratory control of these patients because it reduces morbidity, mortality, and health care costs.
Key words:
multiple injuries
polytrauma
systemic inflammatory response
long bone fractures
high energy impact fractures
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