• Am. J. Surg. · Mar 2002

    Review Comparative Study

    When should we operate on major fractures in patients with severe head injuries?

    • Peter V Giannoudis, Veysi T Veysi, Hans-Christoph Pape, Cristian Krettek, and Malcolm R Smith.
    • Department of Trauma and Orthopaedics, St. James' University Hospital, Leeds, Beckett St., LS9 7TF, Leeds, United Kingdom.
    • Am. J. Surg. 2002 Mar 1; 183 (3): 261-7.

    BackgroundThe widely accepted practice of early fracture fixation (EFF) in multiply injured patients has recently been challenged in the presence of head injury.Data SourcesEnglish and German language articles on the subject were searched using Medline. Keywords included head trauma, intracranial trauma, brain injuries, fractures, fracture fixation, timing, femur fracture, and tibia fracture.ConclusionsThe available literature does not provide clear-cut guidance on the management of fractures in the presence of head injuries. The trend is toward a better outcome if the fractures are fixed early. Treatment should therefore be tailored to the individual patient, with the assumption that full neurologic recovery will take place.

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