• Shaishav Bhagat
  • Bhavik M. Shah


The treatment of patients with multiple injuries changed considerably in the 1970s with the introduction of early fracture fixation. A number of studies showed the value of early femoral fracture fixation in particular, however, and surgeons quickly adopted the philosophy of early total care, fixing all major fractures as soon as possible after admission. This philosophy was challenged in the 1990s by surgeons who pointed out that early time-consuming surgery was not appropriate for all patients, particularly those who were very seriously injured or who presented with severe chest or head trauma. Thus, the concept of damage control surgery was initiated, and this philosophy is widely followed today.


Glasgow Coma Scale Systemic Inflammatory Response Syndrome Injury Severity Score Adult Respiratory Distress Syndrome Abbreviate Injury Scale 
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  1. 1.
    Data from safety on roads, OECD (Organization for Economic Co-operation and Development), 2002.Google Scholar
  2. 2.
    Champion HR, Copes WS, Sacco WJ, et al. The major outcome trauma study: establishing national norms for trauma care. J Trauma. 1990;30:1356–65.PubMedCrossRefGoogle Scholar
  3. 3.
    Dunham CM, Bosse MJ, Clancy TV, et al. Practice management guidelines for the optimal timing of long-bone fracture stabilization in polytrauma patients: the EAST practice management guidelines work group. J Trauma. 2001;50:958–67.PubMedCrossRefGoogle Scholar
  4. 4.
    Pape HC, Giannoudis P, Krettek C. The timing of fracture treatment in polytrauma patients: relevance of damage control orthopedic surgery. Am J Surg. 2002;183:622–9.PubMedCrossRefGoogle Scholar
  5. 5.
    Roberts C, Pape HC, Jones AL, et al. Damage control orthopedics: evolving concepts in the treatment of patients who have sustained orthopedic trauma. J Bone Joint Surg Am. 2005; 87:434–49.Google Scholar
  6. 6.
    Bone RCM. Immunologic dissonance: a continuing evolution in our understanding of the systemic inflammatory response syndrome (SIRS) and the multiple organ dysfunction syndrome (MODS). Ann Intern Med. 1996;125:680–7.PubMedGoogle Scholar
  7. 7.
    Giannoudis PV, Smith RM, Banks RE, et al. Stimulation of inflammatory markers after blunt trauma. Br J Surg. 1998;85:986–90.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2013

Authors and Affiliations

  1. 1.Kettering General HospitalKetteringUK

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