• H Siebert, H Kron, and A Pannike.
• Unfallchirurgie. 1982 Dec 1;8(6):399-404.

AbstractThere are still gradually and even fundamentally different opinions about the most favorable moment for the definitive treatment of lesions of extremities in persons with multiple injuries. The immediate definitive treatment or primary treatment within the first 24 to 48 hours is opposed to a therapy method applying a graduated definitive treatment of the lesions of extremities taking into consideration the individual extent of the injury. During the period from January 1st, 1975 to December 31st, 1979, 321 persons with multiple injuries of degrees 2 and 3 have been treated at the Hospital for Accident Surgery of the University of Frankfurt/Main. 290 fractures were treated in 225 surviving persons with lesions of the extremities. Among 136 fractures of the lower extremities, 118 were operated upon--44 of them immediately and 74 until the end of the fourth week. All femur fractures in surviving persons with multiple injuries were surgically stabilized, with the exception of several cases of isolated fractures of the shank diaphysis who received conservative treatment. Although we consider an early surgical treatment of femur fractures in persons with multiple injuries as the most favorable basis for a continuous and uninterrupted recovery, which we also strive for, the experiences made by us hitherto do not demand a general indication of immediate surgical treatment (within the first 24 hours) of closed femur fractures in persons with multiple injuries. We shall continue to apply a graduated therapy method, considering each individual case, for final treatment of fractures of extremities in persons with multiple injuries.

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