Damage Contol Orthopaedics Involves staging and defininitive management to avoid adding trauma to patient during vulnerable period. The decision to operate and surgical timing on multiple injured trauma patients remains controversial Intra-operative hypotension increases mortality rate in patients with head injury Parameters that help decide who should be treated with DCO ISS >40 (without thoracic trauma) ISS >20 with thoracic trauma Multiple injuries with severe pelvic/abdominal trauma and hemorrhagic shock Bilateral femoral fractures Pulmonary contusion noted on radiographs Hypothermia <35 degrees C Head injury with AIS of 3 or greater Optimal time of surgery Patients are at increased risk of ARDS and multisystem failure during acute inflammatory window (period from 2 to 5 days characterized by a surge in inflammatory markers) Therefore only potentially life-threatening injuries should be treated in this period including : compartment syndrome fractures with vascular injuries unreduced dislocations long bone fractures unstable spine fractures open fractures
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sir i am really a fan of ur teaching. i m amazed how u make every thing so simple and interesting. u r like a god of orthopaedics. all teachers should be like u.
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