Surgical strategy for femoral shaft fractures in severely injured patients: A 13-year experience from a tertiary trauma centre

BackgroundThe treatment strategy of femoral shaft fractures in polytraumatised patients has evolved over the years and led to improved outcomes for these patients. However, there is still controversy regarding optimal surgical care can differ markedly from one country another. We investigate (Early Definitive Care (EDC) or Damage Control Orthopaedics (DCO)) implemented severely injured with treated at a single tertiary trauma centre southern Finland factors affecting decision making.MethodsThe Helsinki Trauma Registry (HTR) was used retrospectively identify (New Injury Severity Score [NISS] ? 16) 2006 through 2018 concomitant fractures. Patients <16 old, isolated head injuries, dead on arrival those admitted >24 h following injury were excluded. Based their initial management strategy, fracture divided into EDC DCO groups compared.ResultsCompared other trauma-registry patients, are younger (30.9 ± 15.9 vs. 47.0 19.7, p<0.001) more often road traffic accidents (64.1% 34.4%, p<0.001). The majority (78%) included underwent EDC. who significantly (NISS: 40.1 11.5 27.8 10.1, longer lengths stay ICU (15.4 9.8 7.5 6.1 days, hospital (29.9 29.6 13.7 11.4 than Decision making based primarily related factors, while non-injury may have contributed choosing approach small number cases.ConclusionEarly definitive prevailing centre. particularly having sustained worse intracranial thoracic injuries. In addition influenced by only minority cases.