title: Damage control nailing.
abstract: The role of intramedullary nailing of the femur and the timing for this procedure in the trauma patient with multiple injuries has been widely debated. Recent literature has advocated the idea of "damage control orthopaedics," promoting temporary external fixation for stabilization of long bone fractures in the acute setting. This paper advances an alternative to damage control orthopaedics, the option of rapidly executed small-diameter unreamed retrograde nailing of the femur for the patient with polytrauma who will be undergoing simultaneous surgery for other injuries. This technique offers the advantages of rapid stabilization performed under controlled circumstances in the operating room, without some of the disadvantages of using external fixation in this situation.
authors.affiliation: University of Utah Department of Orthopaedics, Salt Lake City, Utah 84108, USA. thomas.higgins@hsc.utah.edu
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Higgins
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Horwitz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001858:Bone Nails; D001863:Bone Screws; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation*; D006801:Humans; D007431:Intraoperative Complications / Q000000981:diagnostic imaging / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D016896:Treatment Outcome