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
Department of Trauma, University of Zurich, UniversitätsSpital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
Riverside University Health System and Loma Linda University, Riverside, CA, USA.
Eur J Trauma Emerg Surg. 2021 Dec;47(6):2081-2092. doi: 10.1007/s00068-020-01386-1. Epub 2020 May 26.
The objectives of this study were to gather an expert opinion survey and to evaluate the suitability of summarized indications and interventions for DCO.
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).
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.
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".
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.
本研究的目的是收集专家意见调查结果，并评估损伤控制骨科（DCO）总结的适应症和干预措施的适用性。
在住院期间，进行肌肉骨骼损伤临时手术的适应症可能会有所不同，且尚未明确界定。我们针对损伤控制骨科（DCO）的适应症进行了文献综述和专家意见调查。
第一部分：基于PubMed数据库搜索进行文献综述。筛选以下解剖区域中损伤控制干预措施的出版物：“脊柱”“骨盆”“四肢”和“软组织”。制定了一份标准化问卷，其中包括损伤控制干预措施及相关适应症列表。第二部分：专家意见调查的开展：经验丰富的创伤和骨科外科医生参与了共识达成过程。
第一部分：基于医学主题词检索共获得646篇参考文献。纳入74篇手稿。第二部分：12位多发伤管理领域的专家参加了三次共识会议。我们确定了12种DCO干预措施和79种适应症。在脊柱创伤中，经皮干预被认为是有益的。牵引被认为是有害的。对于孤立损伤，应使用新术语：“肌肉骨骼临时手术”。
本综述详细描述了简化肌肉骨骼手术的管理共识。大家一致认为，早期固定对所有主要骨折至关重要，某些DCO适应症被摒弃。作者提出了一个独特的术语，以区分局部（肌肉骨骼临时手术）与全身（多发伤：DCO）情况。
