Damage Control Orthopaedics by Craig S. Roberts, Hans-Christoph Pape, Alan L. Jones, Arthur L. Malkani, Jorge L. Rodriguez, and Peter V. Giannoudis J Bone.

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Presentation transcript:

Damage Control Orthopaedics by Craig S. Roberts, Hans-Christoph Pape, Alan L. Jones, Arthur L. Malkani, Jorge L. Rodriguez, and Peter V. Giannoudis J Bone Joint Surg Am Volume 87(2): February 1, 2005 ©2005 by The Journal of Bone and Joint Surgery, Inc.

After trauma, there is a balance between the systemic inflammatory response and the counter- regulatory anti-inflammatory response. Craig S. Roberts et al. J Bone Joint Surg Am 2005;87: ©2005 by The Journal of Bone and Joint Surgery, Inc.

Mean plasma elastase concentrations (and 95% confidence intervals) before and after intramedullary nailing of the femur from the time of admission to the emergency room (A&E) to 168 hours after surgery8. Craig S. Roberts et al. J Bone Joint Surg Am 2005;87: ©2005 by The Journal of Bone and Joint Surgery, Inc.

The two-hit theory is shown schematically. Craig S. Roberts et al. J Bone Joint Surg Am 2005;87: ©2005 by The Journal of Bone and Joint Surgery, Inc.

Craig S. Roberts et al. J Bone Joint Surg Am 2005;87: ©2005 by The Journal of Bone and Joint Surgery, Inc.

Craig S. Roberts et al. J Bone Joint Surg Am 2005;87: ©2005 by The Journal of Bone and Joint Surgery, Inc.

Craig S. Roberts et al. J Bone Joint Surg Am 2005;87: ©2005 by The Journal of Bone and Joint Surgery, Inc.

Craig S. Roberts et al. J Bone Joint Surg Am 2005;87: ©2005 by The Journal of Bone and Joint Surgery, Inc.

Staged intramedullary nailing was performed on post-injury day 2. Craig S. Roberts et al. J Bone Joint Surg Am 2005;87: ©2005 by The Journal of Bone and Joint Surgery, Inc.

Craig S. Roberts et al. J Bone Joint Surg Am 2005;87: ©2005 by The Journal of Bone and Joint Surgery, Inc.

Craig S. Roberts et al. J Bone Joint Surg Am 2005;87: ©2005 by The Journal of Bone and Joint Surgery, Inc.

The current treatment algorithm from Hannover, Germany, for the use of damage control orthopaedics is based on a prompt and accurate determination of whether the patient is stable, borderline, unstable, or in extremis. Craig S. Roberts et al. J Bone Joint Surg Am 2005;87: ©2005 by The Journal of Bone and Joint Surgery, Inc.