Abstract
The treatment of multiple trauma patients is subdivided into pre-hospital and hospital periods. The hospital period is divided according to diagnostic and therapeutic measures into acute, primary, secondary, and tertiary periods. In the acute period, all life-threatening injuries, e.g., severe abdominal bleeding, are treated. In the primary period, visceral injuries such as bowel rupture and fractures with vessel injuries, open fractures, open joints, severe compartment syndromes, and closed femoral fractures require surgery. In the secondary period, prolonged joint reconstructions, closed fractures of the forearm, and partially reconstructive surgery are performed. In the tertiary period, reconstructive surgery is done (e.g., cancellous bone grafts). Using this regimen in multiple trauma patients, we not only obtain restoration of vital function, but also good restoration of the extremities is achieved.
Résumé
Le traitement des polytraumatisés subdivise en 2 étapes: avant l'hospitalisation et lors de l'hospitalisation. L'étape initiale d'hospitalisation est ellemême subdivisée en fonction du diagnostic et du traitement en 4 périodes: aiguë, immédiate, secondaire, tardive. Du cours de la première période les blessures mettant la vie en jeu sont traitées ainsi en est-il des lésions abdominales hémmoragiques. Lors de la deuxième période est pris en considération le traitement des ruptures intestinales, des fractures avec lésions vasculaires associées des fractures ouvertes, des fractures articulaires ouvertes, des fractures du fémur. Le traitement secondaire s'applique aux fractures articulaires fermés, aux fractures fermés de l'avant bras. Le traitement tardif répond à la chirurgie reconstructive (griffe osseuse retardée).
En se pliant a ces règles, chez le polytraumatisé, il est non seulement possible de sauver le blessé dont la vie est menacée mais aussi d'aboutir à de bons résultats fonctionnels.
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Tscherne, H., Oestern, H.J. & Sturm, J. Osteosynthesis of major fractures in polytrauma. World J. Surg. 7, 80–87 (1983). https://doi.org/10.1007/BF01655915
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DOI: https://doi.org/10.1007/BF01655915