Indications and interventions of damage control orthopedic surgeries: an expert opinion survey

• Published in: European journal of trauma and emergency surgery (Munich : 2007) 2021-12, Vol.47 (6), p.2081-2092
• Main Authors: Pfeifer, Roman, Kalbas, Yannik, Coimbra, Raul, Leenen, Luke, Komadina, Radko, Hildebrand, Frank, Halvachizadeh, Sascha, Akhtar, Meraj, Peralta, Ruben, Fattori, Luka, Mariani, Diego, Hasler, Rebecca Maria, Lefering, Rolf, Marzi, Ingo, Pitance, François, Osterhoff, Georg, Volpin, Gershon, Weil, Yoram, Wendt, Klaus, Pape, Hans-Christoph
• Format: Article
• Language: English
• Subjects: Bone surgery; Critical Care Medicine; Emergency Medicine; Injuries; Intensive; Joint and ligament injuries; Literature reviews; Medicine; Medicine & Public Health; Original Article; Orthopedics; Pelvis; Spine; Sports Medicine; Surgery; Surgical Orthopedics; Surgical techniques; Terminology; Trauma; Traumatic Surgery
• ISSN: 1863-9933; 1863-9941
• DOI: 10.1007/s00068-020-01386-1

Objectives The objectives of this study were to gather an expert opinion survey and to evaluate the suitability of summarized indications and interventions for DCO. Background The indications to perform temporary surgery in musculoskeletal injuries may vary during the hospitalization and have not been defined. We performed a literature review and an expert opinion survey about the indications for damage control orthopaedics (DCO). Methods Part I: A literature review was performed on the basis of the PubMed library search. Publications were screened for damage control interventions in the following anatomic regions: “Spine”, “Pelvis”, “Extremities” and “Soft Tissues”. A standardized questionnaire was developed including a list of damage control interventions and associated indications. Part II: Development of the expert opinion survey: experienced trauma and orthopaedic surgeons participated in the consensus process. Results Part I: A total of 646 references were obtained on the basis of the MeSH terms search. 74 manuscripts were included. Part II: Twelve experts in the field of polytrauma management met at three consensus meetings. We identified 12 interventions and 79 indications for DCO. In spinal trauma, percutaneous interventions were determined beneficial. Traction was considered harmful. For isolated injuries, a new terminology should be used: “MusculoSkeletal Temporary Surgery”. Conclusion This review demonstrates a detailed description of the management consensus for abbreviated musculoskeletal surgeries. It was consented that early fixation is crucial for all major fractures, and certain indications for DCO were dropped. Authors propose a distinct terminology to separate local (MuST surgery) versus systemic (polytrauma: DCO) scenarios.