Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Trauma - Systemic
Abstract number: 25858
MANAGEMENT OF A PATIENT WITH 10 FRACTURES IN ONE LEG: APPLYING
THE DAMAGE CONTROL CONCEPT
Mahmoud HAFEZ 1 , Ahmed ELMORSY 1 , Amr Mohsen ALI 2 , Ahmed Tamer FARAG 1
1 The Orthopaedic Unit, October 6 University, Cairo (EGYPT), 2 Sheikh Zayed
Specialized Hospital, Cairo (EGYPT)
Trauma is the first cause of death for age 0-45, the third cause of death for all ages.
Several years ago, it was popular to use the total care principle in the management
of polytrauma patients aiming to fix as many fractures as possible in one single
session. Recently, damage-control theory has gained popularity due to the potential
of reducing morbidity and mortality. We present the application of this concept in a 24
year male, who had a car accident & sustained 10 fractures in his left leg. After initial
management & resuscitation the patient had immediate debridement and reduction of
the open fracture dislocation of the 1st metatarsal head and reconstruction nailing for
the fractures of the shaft and neck of femur(intracapsular). The patient was stabilized
again, and two days latter, he had a second look and debridement of open wounds
and fixation of other fractures. Namely; proximal proximal tibia, distal fibula, distal
tibia, & multiple metatarsal fractures. The patient had prophylactic antibiotic and DVT
measures, and started physiotherapy in the first week of treatment.By three months,
the patient was fully weight bearing and showed signs of fracture healing. At 6month-
follow-up the progress was satisfactory and the patient was able to go back to
work on a light duties
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