Simons Tomi, Brinck Tuomas, Handolin Lauri
Duodecim. 2016;132(9):828-35.
Timing of the treatment of orthopaedic injuries in multiply injured patients has undergone changes. The timing of definitive fracture management has varied from several weeks to within hours of injury. In many studies a clear benefit has been identified from early definitive care of long bone fractures: early total care (ETC). The most seriously injured patients benefit from damage control orthopaedics, an approach employing primary external fixator stabilization followed by secondary intramedullary nailing. Debate over these approaches with enhanced understanding of biological response to injury has led to recent emphasis on the need for aggressive patient monitoring and continued multidisciplinary evaluation of the patient's physiological response to treatment.
多发伤患者骨科损伤的治疗时机已经发生了变化。确定性骨折治疗的时机从受伤后数周至数小时不等。在许多研究中，已确定早期对长骨骨折进行确定性治疗具有明显益处：早期全面治疗（ETC）。伤势最严重的患者可从损伤控制骨科治疗中获益，该方法采用初次外固定架稳定，随后进行二次髓内钉固定。随着对损伤生物学反应的深入了解，围绕这些方法的争论导致最近强调需要对患者进行积极监测，并持续对患者对治疗的生理反应进行多学科评估。
