4.3 Article

Femur Shaft Fracture Fixation in Head-Injured Patients: When Is the Right Time?

Journal

JOURNAL OF ORTHOPAEDIC TRAUMA
Volume 24, Issue 2, Pages 107-114

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/BOT.0b013e3181b6bdfc

Keywords

Traumatic brain injury; femur fracture; intramedullary nail fixation; damage control; external fixation

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The ideal timing and modality of femur shaft fracture fixation in head-injured patients remains a topic of debate. Several groups advocate the immediate definitive fixation Of femur fractures (early total care), whereas others support the concept of damage control orthopaedics with temporary fracture fixation by means of external fixation and staged, planned conversion to internal fixation. The present review was designed to address this unresolved controversy by outlining the underlying immunopathophysiology of traumatic brain injury and providing clinical recommendations on the timing of femur shaft fracture fixation in patients with severe head injuries.

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