The importance of early internal fixation in multiply injured patients to prevent late death due to sepsis.
Three hundred and seventy-one multiply injured patients with 1063 fractures, who were admitted to our service over an 8-year period (1978-1985), were studied retrospectively. The impact of early osteosynthesis on the overall, and especially of the late, mortality due to sepsis was analysed. The patients were divided into two groups depending on whether they were treated with osteosynthesis (group I) or underwent conservative fracture treatment (group II). The late mortality (more than 7 days after injury) due to sepsis fell to 1.8 per cent in patients treated with osteosynthesis compared with 13.5 per cent (P less than 0.001) in patients treated conservatively. The best results were obtained when the osteosynthesis was performed within 24 hours after injury; less than 1 per cent died from late sepsis. We feel that fractures in multiply injured patients should be treated with early osteosynthesis in order to reduce the late mortality from sepsis.
D000328:Adult; D001530:Belgium; D005593:Fracture Fixation, Internal; D006801:Humans; D009102:Multiple Organ Failure; D009104:Multiple Trauma / Q000150:complications / Q000401:mortality / Q000601:surgery*; D009894:Opportunistic Infections / Q000150:complications / Q000401:mortality / Q000517:prevention & control*; D012189:Retrospective Studies; D013997:Time Factors