Application of damage control orthopedics in multiple injuries: a study of 41 cases
- VernacularTitle:严重多发伤时损伤控制骨科应用41例
- Author:
Jun YANG
;
Jinmou GAO
;
Shanhong ZHAO
- Publication Type:Journal Article
- Keywords:
Wounds and injuries;
Orthopedic procedures;
Damage control surgery
- From:
Chinese Journal of Trauma
1993;0(05):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To probe the feasibility and efficacy of damage control orthopedics(DCO) in treating multiple injuries.Methods A retrospective analysis was done on clinical data of 41 case with multiple injuries treated by DCO from 1995 to 2005.Results Devascularization of internal iliac arteries was performed in 29 cases with multiple injuries complicated by massive bleeding and fractures of the pelvis,of which 23 were treated with ligation of bilateral internal iliac arteries and eight with angioembolization of bilateral internal iliac arteries.External fixation cage for the pelvis was used in an early period in 10 cases,primary debridement with simple external fixation in 10 with multiple injuries complicated by open femoral fractures and simple laminectomy in two with spinal fractures combined with spinal cord compression.All cases received discriminating internal fixation posterior to resuscitation in ICU.The overall mortality rate was 12.1%(5/41),with average injury severity score(ISS) for 41.4 and with shock and associated injury as the main causes for death.The complications occurred in seven cases including three with acute respiratory distress syndrome(ARDS),one with thrombosis of right common iliac artery,two with subphernic abscess and one with deep wound infection of the lower extremities,all of whom got cured.Conclusions Prompt diagnosis and integration of treatment are key to enhancing the survival rate of multiple injuries.In the meantime,DCO is effective and safe for cases with multiple injuries.
