title: Timing of fracture fixation from an Intensive Care Unit perspective: the obstacles to early fracture fixation.
abstract: Trauma is one of the leading causes of death worldwide, with road traffic accidents being the leading cause of death in the age group of 15-29 years However, with modern advances in management and the introduction of specialised trauma centres, more and more are surviving severe and life-threatening trauma. The ideal timing of fracture fixation has been the subject of debate for a number of decades. There is evidence to suggest that fracture fixation in the patient with polytrauma is best achieved early on to reduce the incidence of morbidity and mortality, with damage control surgery in the more appropriate option in those patients who are haemodynamically unstable. However, early fracture fixation is not always possible, and the focus of this article is to review the common contributing factors resulting in delayed fixation. For the purpose of this discussion, we will consider all trauma as a single entity, taking into account that each type of fixation has its own complications, which are outside the scope of this article.
authors.affiliation: University Hospitals of Coventry and Warwickshire, West Midlands, UK.
authors.forename: Lauren Elizabeth
authors.initials: LE
authors.lastname: Thomson
authors.affiliation: University Hospitals of Coventry and Warwickshire, West Midlands, UK.
authors.forename: Nicola
authors.initials: N
authors.lastname: Fry
authors.affiliation: University Hospitals of Coventry and Warwickshire, West Midlands, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Jackson
mesh_terms: D004635:Emergency Medicine / Q000193:education / Q000379:methods*; D005592:Fracture Fixation / Q000193:education / Q000379:methods*; D006801:Humans; D015601:Injury Severity Score; D007362:Intensive Care Units; D009104:Multiple Trauma / Q000601:surgery*; D017410:Practice Guidelines as Topic; D013997:Time Factors; D014193:Trauma Centers
keywords: TRAUMA MANAGEMENT