Polytrauma care. The effect of head injuries and timing of skeletal fixation.

There is a substantial body of literature supporting early ( < 48 hours) fixation of long bone fractures in the patient with polytrauma. Early fixation reduces the complications of traction and recumbency, reduces pain, decreases the stimulus for a systemic inflammatory response, makes nursing care easier, makes the fracture outcome more predictable, and decreases health care costs. If hypotension and hypoxia are avoided, early fixation of long bone fractures does not increase the incidence of adverse cerebral events. The benefits (short and long term), if any, of early fixation of long bone fractures on the recovery from closed head injury remain poorly defined.