Optimizing the Orthopaedic Trauma Patient- Staged Management

Abstract

Staged management of orthopedic trauma is employed to promote best outcomes and avoid known complications associated with acute definitive fracture reconstruction. Fracture in the setting of polytrauma is often initially managed with temporizing methods to allow for both optimization of the host and local soft tissue environment. Damage control orthopedics has promoted this strategy to delay definitive care of orthopaedic injuries based on the patient's level of resuscitation/inflammatory state. Further, staged care of peri-articular fracture respects the already traumatized soft tissue envelope in an effort to decrease the risk of infamous complications such as infection and fracture nonunion. Typically, external fixation is utilized in staged management and host optimization is performed in the “waiting period.”