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Indications and interventions of damage control orthopedic surgeries: an expert opinion survey

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Objectives

The objectives of this study were to gather an expert opinion survey and to evaluate the suitability of summarized indications and interventions for DCO.

Background

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).

Methods

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.

Results

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”.

Conclusion

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.

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Funding

No funding was received for this work from any of the following organizations: National Institutes of Health (NIH); Wellcome Trust; Howard Hughes Medical Institute (HHMI); and other(s).

Author information

Authors and Affiliations

  1. Department of Trauma, University of Zurich, UniversitätsSpital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland

    Roman Pfeifer, Yannik Kalbas, Sascha Halvachizadeh, Meraj Akhtar, Rebecca Maria Hasler & Hans-Christoph Pape

  2. Riverside University Health System and Loma Linda University, Riverside, CA, USA

    Raul Coimbra

  3. Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands

    Luke Leenen

  4. Department of Traumatology, General and Teaching Hospital Celje, Medical Faculty Ljubljana University, 3000, Celje, Slovenia

    Radko Komadina

  5. Department of Trauma, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany

    Frank Hildebrand

  6. Surgical Department (Hamad General Hospital), Hamad Medical Corporation, HMC, Doha, Qatar

    Ruben Peralta

  7. Department of Surgery, San Gerardo Hospital, University of Milan Bicocca, G.B. Pergolesi 33, Monza, Italy

    Luka Fattori

  8. Department of Emergency General Surgery, Legnano Hospital, ASST Ovest Milanese, Legnano, MI, Italy

    Diego Mariani

  9. IFOM, Institute for Research in Operative Medicine, Faculty of Health, University Witten/Herdecke, Ostmerheimer Straße 200, 51109, Cologne, Germany

    Rolf Lefering

  10. Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Goethe-University, Frankfurt, Germany

    Ingo Marzi

  11. Anesthesiology and Intensive Care Unit, CHR De La Citadelle, Liege, Belgium

    François Pitance

  12. Department of Orthopaedics, Trauma, and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany

    Georg Osterhoff

  13. Department of Orthopedic Surgery, EMMS Hospital, Nazareth, Affiliated to Galilee Medical Faculty Zfat, Bar Ilan University, Ramat Gan, Israel

    Gershon Volpin

  14. Orthopaedic Trauma Unit, Hadassah Hebrew University Hospital, Jerusalem, Israel

    Yoram Weil

  15. Department of Trauma Surgery, University Medical Center Groningen (UMCG), Hanzeplein 1, 9700 RB, Groningen, The Netherlands

    Klaus Wendt

Authors
  1. Roman Pfeifer
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  2. Yannik Kalbas
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  3. Raul Coimbra
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  4. Luke Leenen
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  5. Radko Komadina
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  6. Frank Hildebrand
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  7. Sascha Halvachizadeh
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  8. Meraj Akhtar
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  9. Ruben Peralta
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  10. Luka Fattori
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  11. Diego Mariani
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  12. Rebecca Maria Hasler
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  13. Rolf Lefering
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  14. Ingo Marzi
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  15. François Pitance
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  16. Georg Osterhoff
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  17. Gershon Volpin
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  18. Yoram Weil
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  19. Klaus Wendt
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  20. Hans-Christoph Pape
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Corresponding author

Correspondence to Roman Pfeifer.

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The authors declare that they have no conflict of interest.

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Pfeifer, R., Kalbas, Y., Coimbra, R. et al. Indications and interventions of damage control orthopedic surgeries: an expert opinion survey. Eur J Trauma Emerg Surg 47, 2081–2092 (2021). https://doi.org/10.1007/s00068-020-01386-1

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  • DOI: https://doi.org/10.1007/s00068-020-01386-1

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