Early Total Care vs. Damage Control Orthopedics

Today, there is evidence, that initial stabilization of long bone fractures in multiple trauma patients (NIT) is beneficial to Outcome independent of the procedure performed. Concerning the procedure, there is insufficient evidence whether primary definitive (early total care) or temporary stabilization (damage control) is superior on Survival. The reality reflects the controversies of Current literature. Nevertheless, the rate of temporary external fixation in MT has increased. Predominantly the anatomic and physiologic injury severity appear to influence the therapeutic decision making. Thus, it may be necessary to individualize timing and procedure Of femur stabilization according to the patients' clinical condition. Debate remains on which prognostic factors influence decision making. Thus further randomized trials are necessary.