The Polytrauma Patient

The continuous increase in population density and traffic had led to a serious increase in the severity and frequency of polytrauma patients. Early appropriate care concept emphasizes the relevance of the resuscitation phase during the treatment of the polytrauma patient. The key goal is to make an early assessment of the different injuries of the patient and the need to apply any resuscitation measure in order to save the life. Moving the patient to an institution with the appropriate resources to manage the patients is essential. The aims of fracture management are control of hemorrhage, contamination, prevention of ischemia-reperfusion injury, pain relief and facilitate ventilation, nursing, and physiotherapy. Appropriate survey and evaluation of the patient allows the stratification of the patient into one of four groups: stable, borderline, unstable, and in extremis. This classification will guide the strategy to follow, which may be damage control surgery, early total care, reassessment of patients with deterioration of their previous status and, resuscitation. Orthopedic management decisions include establishing hemodynamic control, resuscitation, and stabilization in a hemodynamically unstable patient with pelvic ring and limb injuries and the fixation strategy will depend on the condition of the patient, fracture characteristics, the degree of bone loss, vascular injury, soft tissue condition, and level of contamination.