Damage Control Orthopedics-Damage Control Orthopedics

Damage Control Orthopedics

Pdf Summary

Damage Control Orthopedics is a concept that originated in the medical field, specifically in orthopedics, and is intended to provide limited initial treatment for trauma patients before definitive fracture care can be given. The concept emerged in the 1990s and was a paradigm shift in the approach to treating severe trauma. Early studies showed that early stabilization of fractures reduced the incidence of complications such as Fat Embolism Syndrome and acute respiratory distress syndrome. Damage Control Orthopedics involves treating the most severe systemic inflammatory response first, followed by definitive fracture care once the response has resolved, usually more than 4-5 days after the injury. The concept is based on the idea of a "2-Hit" hypothesis, where the trauma itself is the first hit and the surgery is the second hit, and the goal is to minimize blood loss, mediator release, and other complications. However, it is important to use Damage Control Orthopedics techniques judiciously, as they can lead to unnecessary prolongation of stay in the ICU, longer hospital stays, and delayed mobilization. The approach to trauma patients should be based on their clinical condition, categorizing them as stable, borderline, unstable, or in extremis, and providing appropriate care accordingly. The economic burden of trauma-related injuries is significant, with healthcare costs and lost productivity amounting to $671 billion annually.

Keywords

Damage Control Orthopedics

trauma patients

definitive fracture care

early stabilization

complications

systemic inflammatory response

2-Hit hypothesis

blood loss

ICU

economic burden