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

Am J Surg. 2002 Mar;183(3):261-7. doi: 10.1016/s0002-9610(02)00783-3.

Abstract

Background: The widely accepted practice of early fracture fixation (EFF) in multiply injured patients has recently been challenged in the presence of head injury.

Data sources: English 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.

Conclusions: The 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.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Craniocerebral Trauma / complications
  • Craniocerebral Trauma / diagnosis*
  • Craniocerebral Trauma / mortality
  • Female
  • Femoral Fractures / complications
  • Femoral Fractures / mortality
  • Femoral Fractures / surgery*
  • Fracture Fixation, Internal / adverse effects
  • Fracture Fixation, Internal / methods*
  • Germany
  • Humans
  • Injury Severity Score
  • Male
  • Multiple Trauma / diagnosis
  • Multiple Trauma / mortality
  • Multiple Trauma / surgery*
  • Practice Guidelines as Topic
  • Prognosis
  • Risk Assessment
  • Sensitivity and Specificity
  • Survival Rate
  • Tibial Fractures / complications
  • Tibial Fractures / mortality
  • Tibial Fractures / surgery*
  • Time Factors
  • Triage*