Damage Control in Orthopedics and Traumatology

• Published in: Colombia médica (Cali, Colombia) Colombia), 2021-11, Vol.52 (2), p.e4184802
• Main Authors: Martínez-Rondanelli, Alfredo, Gomez-Sierra, Maria Antonia, Ossa, Arley Alberto, Hernández, Rubén Darío, Torres, Mauricio
• Format: Article
• Language: English
• ISSN: 0120-8322; 1657-9534
• DOI: 10.25100/cm.v52i2.4802

In Orthopedics, damage control is indicated in patients with pelvic and / or long bone fractures associated with unstable general conditions. Given the severity of the trauma associated with hemodynamic instability, it is not appropriate to perform a complex definitive reduction and fixation surgery for all the patient’s fractures. In these cases, its recommended to perform minimally invasive procedures which provide provisional stabilization of the fractures, this reduces pain, controls bleeding from fractures, allows for proper alignment of fractured bones and reduces dislocations, these procedures aim to control the damage of the first hit to reduce complications. Closed or open fractures of the long bones of the femur, tibia, humerus, and pelvis can lead to instability and shock making damage control in orthopedics a priority.  If the patient is hemodynamically stable its recommended to stabilize all fractures with an early permanent internal fixation thereby controlling the damage with less hospitalization time. As a result, there’s a reduction in the time spent in intensive care as well as the need for mechanical ventilation, transfusions and complications. The concept of damage control as the treatment in orthopedic injuries should be individualized according to the general conditions of each patient and the severity of injuries such as open fractures, dislocations, complete dislocation of sacroiliac joint, vascular lesions, amongst others, as these lesions must be a priority in most patients with multiple injuries. This is to avoid complication and that can leave permanent sequalae’s by receiving inadequate initial treatment.