The Journal of Bone and Joint Surgery (American). 2005;87:434-449.
© 2005 The Journal of Bone and Joint Surgery, Inc.
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 Trauma Test 7: Spring 2005
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Instructional Course Lecture

Damage Control Orthopaedics

Evolving Concepts in the Treatment of Patients Who Have Sustained Orthopaedic Trauma

Craig S. Roberts, MD1, Hans-Christoph Pape, MD2, Alan L. Jones, MD3, Arthur L. Malkani, MD1, Jorge L. Rodriguez, MD1 and Peter V. Giannoudis, MD4

1 Departments of Orthopaedic Surgery (C.S.R and A.L.M.) and Surgery (J.L.R.), University of Louisville, 210 East Gray Street, Suite 1003, Louisville, KY 40202. E-mail address for C.S. Roberts: craig.roberts@louisville.edu
2 Department of Trauma Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, Hannover 30625, Germany
3 Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, Dallas, TX 75390-8883
4 Department of Trauma Orthopaedic Surgery, University of Leeds, Beckett Street, Leeds LS9 7TF, United Kingdom

An Instructional Course Lecture, American Academy of Orthopaedic Surgeons

The first 150 words of the full text of this article appear below.


   Introduction
 
Many orthopaedic patients who have sustained multiple injuries benefit from the early total care of major bone fractures. However, the strategy is not the best option, and indeed might be harmful, for some multiply injured patients. Since foregoing all early surgery is not the optimal approach for those patients, the concept of damage control orthopaedics has evolved. Damage control orthopaedics emphasizes the stabilization and control of the injury, often with use of spanning external fixation, rather than immediate fracture repair. The concept of damage control orthopaedics is not new; it has evolved out of the rich history of fracture care and abdominal surgery. This article traces the roots of damage control orthopaedics, reviews the physiologic basis for it, describes the subgroups of patients and injury complexes that are best treated with damage control orthopaedics, reports the early clinical results, and provides a rationale for modern fracture care . . . [Full Text of this Article]


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