Diagnosis and Management of Orthopaedic Injuries in Politraumatized Patients

Abstract

As soon as the initial assesment is completed, with performance of the basic manouvers from ATLS® (Advanced Trauma Life Support), the management of exposed fractures stands among the priorities in the orthopaedic care of the multiple injured pacient. Vigorous washing, proper debrising, antitetanic vaccine and early broad-spectrum antibiotic therapy are cornerstones for their suitable management. Pelvis and hip fractures, often related to high energy trauma, are the only ones that can cause early mortality because of retroperitoneal bleeding, meaning emergency in Traumatology. Lower limb fractures presents with high mortality rates, and the tibia’s are known as the most frequent among those exposed and those in long bones. Despite the femur fractures are less frequent, they use to leave more severe sequelae. Unlike these, scapula, clavicle, radius and ulna fractures receive simple reduction and immobilization, requiring surgical intervention only in particular cases. The radiologic evaluation in multiple trauma pacients should never intefere or postpone the reanimation manouvers. Two orthogonal radiographic incidences are usually enough to visualize most of the orthopaedic injuries. Additional imaging modalities are usually save for later evaluation of more complex injuries and anatomic structures.