Fracture fixation in patients having multiple injuries.

The concept of early surgical stabilization of long-bone fractures in patients with multiple injuries became firmly established in the 1970s and 1980s. During the 1990s questions were raised about the early total care of all long-bone fractures in these patients. In particular, it was pointed out that patients with severe chest injuries and those with severe head injuries require special consideration. Although patients in those circumstances do require careful attention, most of the literature suggests that continued early surgical stabilization of these fractures, in particular femoral neck fractures, is important for patients who suffer polytrauma. The concept of early temporary surgical stabilization (damage control orthopedic surgery) has recently been suggested. In the majority of cases, femoral shaft fractures can be treated with interlocked intramedullary nailing.