Summary
The authors compared the results of a retrospective analysis of two groups of head-injured patients who had coexistent pelvic or lower extremit fractures. One group was treated with early osteosynthesis within the first 12 hours after trauma, simultaneously with neurosurgical treatment, while the second group was treated neurosurgically and osteosynthesis was postponed for 4 to 10 days. The second group revealed a higher mortality, which was due to fat embolism. We conclude that early osteosynthesis is the treatment of choice in patients with coexistent head injury and lower extremity fractures.
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References
Bakay L (1983) Brain injuries in polytrauma. World J Surg 7: 42–48
Bellamy R, Bower T (1974) Management of skeletal trauma in the patient with head injury. J Trauma 14: 1021–1028
Bone L, Buchholz R (1986) The management of fractures in the patient with multiple trauma. J Bone Jt Surg 68-A: 945–949
Garland DE, Rhoades ME (1977) Orthopedic management of brain-injured adults. Clin Orthop 131: 111–122
Gibson JMC (1960) Multiple injuries: the management of the patient with a fractured femur and a head injury. J Bone Jt Surg 42-B: 425–431
Gossling HR, Pellegrini VD (1982) Fat embolism syndrome. A review of the pathophysiological basis of treatment. Clin Orthop 165: 68–82
Gruca A (1983) Chirurgia Ortopedyczna. PZWL, Warszawa
Jennett B, Bond M (1975) Assessment of outcome after severe brain damage. A practical scale. Lancet 1: 480–484
Koslowski L (1968) Behandlungsprobleme bei der Kombination von Schädel-Hirntraumen mit Mehrfachfrakturen an den Gliedmaßen. Langenbecks Arch Chir 322: 1085–1089
Kotwica Z, Jagodziński Z (1987) Multiple injuries in neurotraumatology. In: Wroński J, Wroński M (eds) Cerebral circulatory insufficiency and other neurosurgical problems. Pol Tow N-chir, Wrocław, pp 553–559
Kotwica Z, Jagodziński Z, Balcewicz L (1987) Head injuries complicated by fractures of pelvis or lower extremities. Wiad Lek 40: 383–386
Lam SJS (1964) The place of delayed internal fixation in the treatment of fractures of the long bones. J Bone Jt Surg 46-B: 393–397
Loew F (1979) Das Timing der Versorgung von Kombinationsverletzungen. Zbl Neurochir 40: 281–288
Martens F, Ectors P (1988) Priorities in the management of polytraumatised patients with head injury: partially resolved problems. Acta Neurochir (Wien) 94: 70–73
Riska EB, Myllynen P (1982) Fat embolism with multiple injuries. J Trauma 22: 891–894
Teasdale G, Jennett B (1974) Assessment of coma and impaired consciousness. A practical scale. Lancet 2: 81–84
Weiler S (1971) Die Dringlichkeit von Osteosynthesen bei der Erstversorgung kombinierter Verletzungen. Arch Klin Chir 329: 82–87
Wentzensen A, Evers KH (1988) Versorgungsstrategie von Mehrfachfrakturen langer Röhrenknochen im Rahmen des Polytraumas. Akt Traumatol 18: 2–6
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Kotwica, Z., Balcewicz, L. & Jagodzinski, Z. Head injuries coexistent with pelvic or lower extremity fractures-early or delayed osteosynthesis. Acta neurochir 102, 19–21 (1990). https://doi.org/10.1007/BF01402180
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DOI: https://doi.org/10.1007/BF01402180