RT Journal Article
SR Electronic
T1 Orthopaedic traumatology: fundamental principles and current controversies for the acute care surgeon
JF Trauma Surgery & Acute Care Open
FD BMJ Publishing Group Ltd
SP e000117
DO 10.1136/tsaco-2017-000117
VO 3
IS 1
A1 Shad K Pharaon
A1 Shawn Schoch
A1 Lucas Marchand
A1 Amer Mirza
A1 John Mayberry
YR 2018
UL http://tsaco.bmj.com/content/3/1/e000117.abstract
AB Multiply injured patients with fractures are co-managed by acute care surgeons and orthopaedic surgeons. In most centers, orthopaedic surgeons definitively manage fractures, but preliminary management, including washouts, splinting, reductions, and external fixations, may be performed by selected acute care surgeons. The acute care surgeon should have a working knowledge of orthopaedic terminology to communicate with colleagues effectively. They should have an understanding of the composition of bone, periosteum, and cartilage, and their reaction when there is an injury. Fractures are usually fixed urgently, but some multiply injured patients are better served with a damage control strategy. Extremity compartment syndrome should be suspected in all critically injured patients with or without fractures and a low threshold for compartment pressure measurements or empiric fasciotomy maintained. Acute care surgeons performing rib fracture fixation and other chest wall injury reconstructions should follow the principles of open fracture reduction and stabilization.