[Benefit of the stabilization of long-bone fractures in polytraumatized patients]. / Beneficio de la estabilización de fracturas de huesos largos en politraumatizados.

INTRODUCTION: Early fracture fixation is increasingly common in medical practice, and femur shaft fractures are the perfect prototype of the lesion warranting early surgery in polytraumatized patients. Damage control orthopedics (DCO) is defined as the minimally-traumatic interventions intended to provide quick stabilization of orthopedic injuries to minimize the systemic inflammatory response. MATERIAL AND METHODS: By means of an evidence-based medicine tool (CAT) we approach the benefit of long-bone fracture stabilization in polytraumatized patients trying to answer a specific clinical question from a concrete situation: What is the evidence of the safety and benefit of early stabilization of long-bone fractures in polytraumatized patients? RESULTS: The patient group whose fractures were stabilized after 48 hours had more clinical complications, alterations of lung parameters and a longer hospital stay. There is no complete evidence showing that early stabilization of long bones in patients with moderate or severe head trauma worsens or improves the outcomes. CONCLUSIONS: Urgent fracture stabilization should be an adjuvant to resuscitation. Early fracture stabilization contributes to reducing the ICU stay, the incidence of acute respiratory distress syndrome (ARDS), multiple organ failure (MOF) and sepsis, thus improving patient survival.

False aneurysm in an ileofemoral Dacron graft after total hip arthroplasty.

A 54-year-old woman patient had received a complete Zweymüller-type prosthesis of the left hip 9 years previously. The heat generated by the setting of the cement produced a thrombosis of the common femoral artery, and an ileofemoral Dacron graft was made. After the 9 year period, the acetabular component was clearly loosened, and a replacement was attempted during which the existence of a pseudoaneurysm, the result of erosion of the Dacron graft by the cement pin, was discovered.