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The review presents the results of experimental and clinical studies of the effect of early osteosynthesis in the femoral fracture on the development of systemic complications and the outcome of polytrauma with chest injuries. We explored the role of combination of thoracic injuries with a fracture of the femur, as well as its intramedullary osteosynthesis in the mechanisms of local and systemic inflammatory reaction formation, coagulopathy, fatty embolism and pulmonary embolism, respiratory failure. The concepts of “immediate total care” and “orthopedic damage control” are described with reference to fractures of the femur, combined with a chest trauma. The criteria for the relative safety of osteosynthesis of the femur in polytrauma with thoracic injuries are given.

Objectives: To report our experience of regional referral center for the pelvis. Methods: We treated 526 pelvic fractures from January 2004 to December 2014 in three regional reference centers for pelvic trauma. Men were 480 and women were 46 and ages ranged from 16 to 93 years old. Car (65%) and farm (20%) crashes were the most frequent causes of pelvis fractures. Injury severity scores ranged from 9.0 to 75.0, with a mean of 37.5. A defined algorithm for fracture management has been in place and employed to assure adequate resuscitation and fracture care. Results: There were 24 deaths in total (4.56%). Sixty three (11.98%) patients underwent angio-embolization for control of bleeding (12 deaths). The average amount of blood transfused was 8.3 IU. Hospital lengths of stay ranged between 1-35 days. Among the 502 alive patients, 55.98% were able to be discharged at home while the remaining 44.02% being transferred to various rehabilitation facilities or extended care facilities. Conclusions: The goal of initial management is to restore vital indicators, urinary excretion function and protect the patient from infectious complications. An emergency decisional algorithm helps manage hemodynamic instability. Initial bone and ligament procedures should reduce displacement and make it possible for the patient to wait until his condition is stable enough for definitive surgical fixation.

Objectives To report our experience of regional referral center for the pelvis. Methods We treated 526 pelvic fractures from January 2004 to December 2014 in three regional reference centers for pelvic trauma. Men were 480 and women were 46 and ages ranged from 16 to 93 years old. Car (65%) and farm (20%) crashes were the most frequent causes of pelvis fractures. Injury severity scores ranged from 9.0 to 75.0, with a mean of 37.5. A defined algorithm for fracture management has been in place and employed to assure adequate resuscitation and fracture care. Results There were 24 deaths in total (4.56%). Sixty three (11.98%) patients underwent angio-embolization for control of bleeding (12 deaths). The average amount of blood transfused was 8.3 IU. Hospital lengths of stay ranged between 1-35 days. Among the 502 alive patients, 55.98% were able to be discharged at home while the remaining 44.02% being transferred to various rehabilitation facilities or extended care facilities. Conclusions The goal of initial management is to restore vital indicators, urinary excretion function and protect the patient from infectious complications. An emergency decisional algorithm helps manage hemodynamic instability. Initial bone and ligament procedures should reduce displacement and make it possible for the patient to wait until his condition is stable enough for definitive surgical fixation. [ABSTRACT FROM AUTHOR]