Hafner Tobias, Horst Klemens, Hildebrand Frank
Klinik für Orthopädie, Unfall- und Wiederherstellungschirurgie, Universitätsklinikum RWTH Aachen, AöR, Pauwelsstr. 30, 52074, Aachen, Deutschland.
Unfallchirurgie (Heidelb). 2022 Jul;125(7):559-567. doi: 10.1007/s00113-022-01192-x. Epub 2022 Jun 10.
The management of polytrauma patients is a complex multidisciplinary and dynamic task. The early and comprehensive assessment of the clinical condition is of great importance with respect to the timing and the individual decision-making on surgical fracture treatment. Stable patients benefit from early definitive fracture treatment, whereas for unstable patients, the concept of multistage fracture treatment with temporary minimally invasive stabilization has gained wide acceptance. These concepts, known as early total care (ETC) and damage control orthopedics (DCO), have been extended in recent decades by dynamic and injury-adapted treatment protocols, such as early appropriate care (EAC) or safe definitive orthopedic surgery (SDS): Therefore, patients in an initially unclear condition (borderline patients) can now also be treated with an individually adapted care concept as soon as possible.
多发伤患者的管理是一项复杂的多学科动态任务。临床状况的早期全面评估对于手术骨折治疗的时机和个体化决策至关重要。病情稳定的患者受益于早期确定性骨折治疗，而对于不稳定患者，采用临时微创稳定的多阶段骨折治疗概念已被广泛接受。这些概念，即早期全面护理（ETC）和损伤控制骨科（DCO），在近几十年中已通过动态且适应损伤的治疗方案得到扩展，如早期适当护理（EAC）或安全确定性骨科手术（SDS）：因此，初始状况不明的患者（临界患者）现在也可以尽快采用个体化的护理概念进行治疗。
