Principles of management
Primary aim - healing with preservation of function. Stages:
- resuscitation - ATLS - airway, breathing, circulation, disability, exposure
- reduction - restore the anatomy, relieve pressure on surrounding nerves, vessels, muscle
- stabilisation - hold the reduced fracture
- rehabilitation - restore function
Assume all open fractures are contaminated and prevent progress to infection.
There is evidence that multiply-injured patients with limb fractures have a reduced mortality rate if these are dealt with at the time of admission rather than after a delay in order to stabilise cardiorespiratory function.
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