• Colomb Medica · Apr 2021

    Review

    Damage control in orthopaedical and traumatology.

    • Alfredo Martínez Rondanelli, María Antonia Gómez-Sierra, Arley Alberto Ossa, Rubén Darío Hernández, and Mauricio Torres.
    • Fundación Valle del Lili, Departamento de Cirugía Ortopédica, Cali, Colombia.
    • Colomb Medica. 2021 Apr 1; 52 (2): e4184802.

    AbstractIn Orthopedics, damage control is indicated in patients with pelvic and/or long bone fractures associated with hemodynamic instability. It is inappropriate to perform a complex definitive reduction and fixation surgery for severely injured trauma patients with hemodynamic instability. In these cases, it is recommended to perform minimally invasive procedures that temporarily stabilize the fractures and bleeding control. Closed or open fractures of the long bones such as femur, tibia, humerus, and pelvis can lead to hemodynamic instability and shock. Thus, orthopedic damage control becomes a priority. However, if the patient is hemodynamically stable, it is recommended to stabilize all fractures with an early permanent internal fixation. These patients will have a shorter hospital length of stay and a reduction in mechanical ventilation, blood components transfusions and complications. Therefore, the concept of orthopedic damage control should be individualized according to the hemodynamic status and the severity of the injuries. Open fractures, dislocations, and vascular injuries could lead to permanent sequelae and complications if a correct management and approach are not performed.Copyright © 2021 Colombia Medica.

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