RESUMO
<p><b>OBJECTIVE</b>To investigate the opportune time of secondary definitive surgery for patients with multiple injuries from earthquakes based on the acute physiology and chronic health evaluation II (APACHE II) score and the principles of damage control.</p><p><b>METHODS</b>Twenty-one patients with critical earthquake injuries were treated with damage control strategies, followed by medical support and surgical intervention to restore their physical potential in the intensive care unit (ICU). Successive APACHE II scoring was adopted to evaluate the patients'physiological status, and then, internal fixation of fractures and other definitive operations were performed.</p><p><b>RESULTS</b>All the patients were effectively treated with few complications, low deformity rate and no death.</p><p><b>CONCLUSIONS</b>Appropriate evaluation of patients?physiological potential, right decision on surgical time and proper operative method can reduce the rates of complications, disability and death for patients with critical earthquake injuries.</p>