principles of management

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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.

Last reviewed 01/2018