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首页> 外文期刊>Injury >The timing of definitive fixation for major fractures in polytrauma--a matched-pair comparison between a US and European level I centres: analysis of current fracture management practice in polytrauma.
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The timing of definitive fixation for major fractures in polytrauma--a matched-pair comparison between a US and European level I centres: analysis of current fracture management practice in polytrauma.

机译：最终确定多发伤严重骨折的固定时间-美国和欧洲I级中心之间的配对比较：当前多发伤骨折管理实践的分析。

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PURPOSE: Early definitive stabilisation is usually the treatment of choice for major fractures in polytrauma patients. Modifications may be made when patients are in critical condition, or when associated injuries dictate the timing of surgery. The current study investigates whether the timing of fracture treatment is different in different trauma systems. MATERIALS AND METHODS: Consecutive patients treated a Level I trauma centre were documented (Group US) and a matched-pair group was gathered from the German Trauma Registry (Group GTR). Inclusion criteria: New Injury Severity Score (NISS)>16, >2 major fractures and >1 organ/soft tissue injury. The timing and type of surgery for major fractures was recorded, as were major complications. RESULTS: 114 patients were included, n=57 Group US (35.1% F, 64.9% M, mean age: 44.1 yrs+/-16.49, mean NISS: 27.4+/-8.65, mean ICU stay: 10+/-7.49) and n=57 Group GTR (36.8% F, 63.1% M, mean age: 41.2 yrs+/-15.35, mean NISS: 29.4+/-6.88, mean ICU stay: 15.6+/-18.25). 44 (57.1%) out of 77 fractures in Group US received primary definitive fracture fixation compared to 61 (65.5%) out of 93 fractures in Group GTR (n.s.). The average duration until definitive treatment was comparable in all major extremity fractures (pelvis: 5 days+/-2.8 Group US, 7.1 days+/-9.6 Group GTR (n.s.), femur: 7.9 days+/-8.3 Group US, 5.5 days+/-7.9 (n.s.), tibia: 6.2 days+/-5.6 Group US, 6.2 days+/-9.1 Group GTR (n.s.), humerus: 5 days+/-3.7 Group US, 6.6 days+/-6.1 Group GTR (n.s.), radius: 6 days+/-4.7 Group US, 6.1 days+/-8.7 Group GTR (n.s.). CONCLUSION: The current matched-pair analysis demonstrates that the timing of initial definitive fixation of major fractures is comparable between the US and Europe. Certain fractures are stabilised internally in a staged fashion regardless the trauma system, thus discounting previous apparent contradictions.
机译：目的：早期确定的稳定通常是多发伤患者大骨折的治疗选择。当患者处于危急状况或相关伤害决定手术时机时，可以进行修改。当前的研究调查在不同的创伤系统中骨折治疗的时机是否不同。材料与方法：记录了治疗I级创伤中心的连续患者（美国组），并从德国创伤登记处（GTR组）收集了一个配对对。纳入标准：新损伤严重度评分（NISS）> 16，严重骨折> 2，器官/软组织损伤> 1。记录了主要骨折的手术时间和类型，以及主要并发症。结果：共纳入114例患者，n = 57组US（35.1％F，64.9％M，平均年龄：44.1岁+/- 16.49，平均NISS：27.4 +/- 8.65，平均ICU停留时间：10 +/- 7.49）和n = 57组GTR（36.8％F，63.1％M，平均年龄：41.2岁+/- 15.35，平均NISS：29.4 +/- 6.88，平均ICU停留时间：15.6 +/- 18.25）。 US组77例骨折中有44例（57.1％）接受了最终确定性骨折固定，而GTR组（n.s.）93例骨折中有61例（65.5％）得到了初步固定。最终治疗的平均持续时间在所有大四肢骨折中均具有可比性（骨盆：5天+/- 2.8组美国，7.1天+/- 9.6组GTR（ns），股骨：7.9天+/- 8.3组美国，5.5天+/- 7.9 （ns），胫骨：6.2天+/- 5.6组美国，6.2天+/- 9.1组GTR（ns），肱骨：5天+/- 3.7组美国，6.6天+/- 6.1组GTR（ns），半径：6天+ /-4.7美国组，6.1天+/- 8.7组GTR（ns）结论：当前的配对分析表明，美国和欧洲的主要骨折初步确定性固定的时间相当，某些骨折在美国内部稳定。无论创伤系统如何，都采用分阶段的方式，从而消除了以前明显的矛盾。

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