Femur shaft fracture fixation in head-injured patients: When is the right time?

Journal of Orthopaedic Trauma

Volumn 24, Issue 2, 2010, Pages 107-114

  Flierl, Michael A ^a   Stoneback, Jason W ^a   Beauchamp, Kathryn M ^a   Hak, David J ^a   Morgan, Steven J ^a   Smith, Wade R ^a   Stahel, Philip F ^a  

^a UNIVERSITY OF COLORADO SCHOOL OF MEDICINE   (United States)

Author keywords

Damage control; External fixation; Femur fracture; Intramedullary nail fixation; Traumatic brain injury

Indexed keywords

MANNITOL;

BLOOD BRAIN BARRIER; CEREBROSPINAL FLUID; CLINICAL ASSESSMENT; FEMUR SHAFT FRACTURE; FRACTURE EXTERNAL FIXATION; FRACTURE FIXATION; GLASGOW COMA SCALE; HUMAN; HYPERCAPNIA; HYPERGLYCEMIA; HYPOGLYCEMIA; HYPOTENSION; HYPOXEMIA; IMMUNE DEFICIENCY; INTRACRANIAL PRESSURE; INTRAMEDULLARY NAIL; MEAN ARTERIAL PRESSURE; PRIORITY JOURNAL; RESUSCITATION; REVIEW; TRAUMATIC BRAIN INJURY;

BRAIN INJURIES; CRITICAL PATHWAYS; FEMORAL FRACTURES; FRACTURE FIXATION; GLASGOW COMA SCALE; HUMANS; OUTCOME AND PROCESS ASSESSMENT (HEALTH CARE); TIME FACTORS;

EID: 77649093333     PISSN: 08905339     EISSN: None     Source Type: Journal    
DOI: 10.1097/BOT.0b013e3181b6bdfc     Document Type: Review

References (96)

1. Hyder AA, Wunderlich CA, Puvanachandra P, et al. The impact of traumatic brain injuries: a global perspective. Neurorehabilitation. 2007; 22:341-353.
2. Mascia L, Sakr Y, Pasero D, et al. Extracranial complications in patients with acute brain injury: a post-hoc analysis of the SOAP study. Intensive Care Med. 2008;34:720-727.
3. Glenn JN, Miner ME, Peltier LF. The treatment of fractures of the femur in patients with head injuries. Clin Orthop Relat Res. 2004;422: 142-144.
4. Grotz MR, Giannoudis PV, Pape HC, et al. Traumatic brain injury and stabilisation of long bone fractures: an update. Injury. 2004;35: 1077-1086.
5. Orliaguet GA, Meyer PG, Baugnon T. Management of the critically ill children with traumatic brain injury. Paediatr Anaesth. 2008;18:455-461.
6. Bayir H, Clark RS, Kochanek PM. Promising strategies to minimize secondary brain injury after head trauma. Crit Care Med. 2003;31: S112-S117.
7. Masson F, Thicoipe M, Aye P, et al. Epidemiology of severe brain injuries: a prospective population-based study. J Trauma. 2001;51:481-489.
8. Stahel PF, Smith WR. Closed head injury. In: Bland KI, Büchler MW, Csendes A, et al, eds. General Surgery: Principles and International Practice. 2nd ed. London: Springer; 2009:131-142.
9. Jeremitsky E, Omert L, Dunham CM, et al. Harbingers of poor outcome the day after severe brain injury: hypothermia, hypoxia, and hypoperfusion. J Trauma. 2003;54:312-319.
10. Wu XH, Shi XY, Gan JX, et al. Dynamically monitoring tissue factor and tissue factor pathway inhibitor following secondary brain injury. Chin J Traumatol. 2003;6:114-117.
11. Morganti-Kossmann MC, Rancan M, Otto VI, et al. Role of cerebral inflammation after traumatic brain injury: a revisited concept. Shock. 2001;16:165-177.
12. Schmidt OI, Heyde CE, Ertel W, et al. Closed head injury-an inflammatory disease? Brain Res Brain Res Rev. 2005;48:388-399.
13. Elf K, Nilsson P, Enblad P. Prevention of secondary insults in neurointensive care of traumatic brain injury. Eur J Trauma. 2003;29: 74-80.
14. Leker RR, Shohami E. Cerebral ischemia and trauma-different etiologies yet similar mechanisms: neuroprotective opportunities. Brain Res Rev. 2002;39:55-73.
15. Neugebauer E, Hensler T, Rose S, et al. Severe craniocerebral trauma in multiple trauma. An assessment of the interaction of local and systemic mediator responses (German). Unfallchirurg. 2000;103:122-131.
16. Morganti-Kossmann MC, Rancan M, Stahel PF, et al. Inflammatory response in acute traumatic brain injury: a double-edged sword. Curr Opin Crit Care. 2002;8:101-105.
17. Ransohoff RM. Chemokines in neurological trauma models. Ann N Y Acad Sci. 2002;961:346-349.
18. Ghirnikar RS, Lee YL, Eng LF. Inflammation in traumatic brain injury: role of cytokines and chemokines. Neurochem Res. 1998;23:329-340.
19. Ransohoff RM. The chemokine system in neuroinflammation: an update. J Infect Dis. 2002;186(Suppl 2):S152-S156.
20. Stahel PF, Morganti-Kossmann MC, Kossmann T. The role of the complement system in traumatic brain injury. Brain Res Rev. 1998;27: 243-256.
21. Zhuang J, Shackford SR, Schmoker JD, et al. The association of leukocytes with secondary brain injury. J Trauma. 1993;35:415-422.
22. Schoettle RJ, Kochanek PM, Magargee MJ, et al. Early polymorphonuclear leukocyte accumulation correlates with the development of posttraumatic cerebral edema in rats. J Neurotrauma. 1990;7:207-217.
23. Golding EM. Sequelae following traumatic brain injury. The cerebrovascular perspective. Brain Res Rev. 2002;38:377-388.
24. Finfer SR, Cohen J. Severe traumatic brain injury. Resuscitation. 2001;48: 77-90.
25. Gebhard F, Huber-Lang M. Polytrauma-pathophysiology and management principles. Langenbecks Arch Surg. 2008;393:825-831.
26. Stahel PF, Smith WR, Moore EE. Role of biological modifiers regulating the immune response after trauma. Injury. 2007;38:1409-1422.
27. Woolf PD. Hormonal responses to trauma. Crit Care Med. 1992;20: 216-226.
28. Tracey KJ. The inflammatory reflex. Nature. 2002;420:853-859.
29. Tracey KJ, Czura CJ, Ivanova S. Mind over immunity. FASEB J. 2001;15: 1575-1576.
30. Arand M, Melzner H, Kinzl L, et al. Early inflammatory mediator response following isolated traumatic brain injury and other major trauma in humans. Langenbecks Arch Surg. 2001;386:241-248.
31. Chesnut RM, Marshall SB, Piek J, et al. Early and late systemic hypotension as a frequent and fundamental source of cerebral ischemia following severe brain injury in the Traumatic Coma Data Bank. Acta Neurochir Suppl (Wien). 1993;59:121-125.
32. Reed AR, Welsh DG. Secondary injury in traumatic brain injury patients-a prospective study. S Afr Med J. 2002;92:221-224.
33. Stahel PF, Heyde CE, Ertel W. Current concepts of polytrauma management. Eur J Trauma. 2005;31:200-211.
34. Davis DP, Serrano JA, Vilke GM, et al. The predictive value of field versus arrival Glasgow Coma Scale score and TRISS calculations in moderateto- severe traumatic brain injury. J Trauma. 2006;60:985-990.
35. Bratton SL, Chestnut RM, Ghajar J, et al. Guidelines for the management of severe traumatic brain injury. I. Blood pressure and oxygenation. J Neurotrauma. 2007;24(Suppl 1):S7-S13.
36. Bratton SL, Chestnut RM, Ghajar J, et al. Guidelines for the management of severe traumatic brain injury. VIII. Intracranial pressure thresholds. J Neurotrauma. 2007;24(Suppl 1):S55-S58.
37. Bratton SL, Chestnut RM, Ghajar J, et al. Guidelines for the management of severe traumatic brain injury. VI. Indications for intracranial pressure monitoring. J Neurotrauma. 2007;24(Suppl 1):S37-S44.
38. Edwards P, Arango M, Balica L, et al. Final results of MRC CRASH, a randomised placebo-controlled trial of intravenous corticosteroid in adults with head injury-outcomes at 6 months. Lancet. 2005;365: 1957-1959.
39. Roberts I, Yates D, Sandercock P, et al. Effect of intravenous corticosteroids on death within 14 days in 10008 adults with clinically significant head injury (MRC CRASH trial): randomised placebo-controlled trial. Lancet. 2004;364:1321-1328.
40. Bratton SL, Chestnut RM, Ghajar J, et al. Guidelines for the management of severe traumatic brain injury. IX. Cerebral perfusion thresholds. J Neurotrauma. 2007;24(Suppl 1):S59-S64.
41. Bratton SL, Chestnut RM, Ghajar J, et al. Guidelines for the management of severe traumatic brain injury. VII. Intracranial pressure monitoring technology. J Neurotrauma. 2007;24(Suppl 1):S45-S54.
42. Stahel PF, Heyde CE, Wyrwich W, et al. Current concepts of polytrauma management: from ATLS to 'damage control' [in German]. Orthopade. 2005;34:823-836.
43. Stahel PF, Smith WR, Moore EE. Hypoxia and hypotension, the 'lethal duo' in traumatic brain injury: implications for prehospital care. Intensive Care Med 2008;34:402-404.
44. Stiefel MF, Udoetuk JD, Storm PB, et al. Brain tissue oxygen monitoring in pediatric patients with severe traumatic brain injury. J Neurosurg. 2006; 105:281-286.
45. Holcomb JB. Damage control resuscitation. J Trauma. 2007;62:S36-S37.
46. Holcomb JB, Jenkins D, Rhee P, et al. Damage control resuscitation: directly addressing the early coagulopathy of trauma. J Trauma. 2007;62: 307-310.
47. Spahn DR, Cerny V, Coats TJ, et al. Management of bleeding following major trauma: a European guideline. Crit Care. 2007;11:R17.
48. Stahel PF, Moore EE, Schreier SL, et al. Transfusion strategies in postinjury coagulopathy. Curr Opin Anest. 2009;22:289-298.
49. Diaz-Parejo P, Stahl N, Xu W, et al. Cerebral energy metabolism during transient hyperglycemia in patients with severe brain trauma. Intensive Care Med. 2003;29:544-550.
50. Garg R, Chaudhuri A, Munschauer F, et al. Hyperglycemia, insulin, and acute ischemic stroke: a mechanistic justification for a trial of insulin infusion therapy. Stroke. 2006;37:267-273.
51. Kinoshita K, Kraydieh S, Alonso O, et al. Effect of posttraumatic hyperglycemia on contusion volume and neutrophil accumulation after moderate fluid-percussion brain injury in rats. J Neurotrauma. 2002;19: 681-692.
52. Holbein M, Bechir M, Ludwig S, et al. Differential influence of arterial blood glucose on cerebral metabolism following severe traumatic brain injury. Crit Care. 2009;13:R13.
53. Sagraves SG, Toschlog EA, Rotondo MF. Damage control surgery-the intensivist's role. J Intensive Care Med. 2006;21:5-16.
54. Spinella PC, Priestley MA. Damage control mechanical ventilation: ventilator induced lung injury and lung protective strategies in children. J Trauma. 2007;62:S82-S83.
55. Stahel PF, Ertel W, Heyde CE. Traumatic brain injury: impact on timing and modality of fracture care [in German]. Orthopade. 2005;34: 852-864.
56. Keel M, Trentz O. Pathophysiology of polytrauma. Injury. 2005;36: 691-709.
57. Rose S, Marzi I. Mediators in polytrauma-pathophysiological significance and clinical relevance. Langenbecks Arch Surg. 1998;383:199-208.
58. Bone LB, Johnson KD, Weigelt J, et al. Early versus delayed stabilization of femoral fractures. A prospective randomized study. J Bone Joint Surg Am. 1989;71:336-340.
59. Bose D, Tejwani NC. Evolving trends in the care of polytrauma patients. Injury. 2006;37:20-28.
60. Giannoudis PV, Veysi VT, Pape HC, et al. When should we operate on major fractures in patients with severe head injuries? Am J Surg. 2002; 183:261-267.
61. Kalb DC, Ney AL, Rodriguez JL, et al. Assessment of the relationship between timing of fixation of the fracture and secondary brain injury in patients with multiple trauma. Surgery. 1998;124:739-744.
62. Velmahos GC, Arroyo H, Ramicone E, et al. Timing of fracture fixation in blunt trauma patients with severe head injuries. Am J Surg. 1998;176: 324-329.
63. Wang MC, Temkin NR, Deyo RA, et al. Timing of surgery after multisystem injury with traumatic brain injury: effect on neuropsychological and functional outcome. J Trauma. 2007;62:1250-1258.
64. Bhandari M, Guyatt GH, Khera V, et al. Operative management of lower extremity fractures in patients with head injuries. Clin Orthop Relat Res. 2003;407:187-198.
65. Kotwica Z, Balcewicz L, Jagodzinski Z. Head injuries coexistent with pelvic or lower extremity fractures-early or delayed osteosynthesis. Acta Neurochir (Wien). 1990;102:19-21.
66. Poole GV, Miller JD, Agnew SG, et al. Lower extremity fracture fixation in head-injured patients. J Trauma. 1992;32:654-659.
67. Reynolds MA, Richardson JD, Spain DA, et al. Is the timing of fracture fixation important for the patient with multiple trauma? Ann Surg. 1995; 222:470-478.
68. Hofman PA, Goris RJ. Timing of osteosynthesis of major fractures in patients with severe brain injury. J Trauma. 1991;31:261-263.
69. Nau T, Aldrian S, Koenig F, et al. Fixation of femoral fractures in multipleinjury patients with combined chest and head injuries. ANZ J Surg. 2003; 73:1018-1021.
70. Brundage SI, McGhan R, Jurkovich GJ, et al. Timing of femur fracture fixation: effect on outcome in patients with thoracic and head injuries. J Trauma. 2002;52:299-307.
71. Seibel R, LaDuca J, Hassett JM, et al. Blunt multiple trauma (ISS 36), femur traction, and the pulmonary failure-septic state. Ann Surg. 1985; 202:283-295.
72. Johnson KD, Cadambi A, Seibert GB. Incidence of adult respiratory distress syndrome in patients with multiple musculoskeletal injuries: effect of early operative stabilization of fractures. J Trauma. 1985;25: 375-384.
73. Charash WE, Fabian TC, Croce MA. Delayed surgical fixation of femur fractures is a risk factor for pulmonary failure independent of thoracic trauma. J Trauma. 1994;37:667-672.
74. Starr AJ. Timing fracture repair in patients with severe brain injury (Glasgow Coma Scale Score ,9). J Trauma. 1998;45:980.
75. Mousavi M, Kolonja A, Schaden E, et al. Intracranial pressure-alterations during controlled intramedullary reaming of femoral fractures: an animal study. Injury. 2001;32:679-682.
76. Lehmann U, Reif W, Hobbensiefken G, et al. Effect of primary fracture management on craniocerebral trauma in polytrauma. An animal experiment study [in German]. Unfallchirurg. 1995;98:437-441.
77. Anglen JO, Luber K, Park T. The effect of femoral nailing on cerebral perfusion pressure in head-injured patients. J Trauma. 2003;54: 1166-1170.
78. Forteza AM, Koch S, Romano JG, et al. Transcranial Doppler detection of fat emboli. Stroke. 1999;30:2687-2691.
79. Townsend RN, Lheureau T, Protech J, et al. Timing fracture repair in patients with severe brain injury (Glasgow Coma Scale score ,9). J Trauma. 1998;44:977-982.
80. Jaicks RR, Cohn SM, Moller BA. Early fracture fixation may be deleterious after head injury. J Trauma. 1997;42:1-5.
81. Stahel PF, Smith WR, Moore EE. Hypoxia and hypotension, the 'lethal duo' in traumatic brain injury: implications for prehospital care. Intensive Care Med. 2008;34:402-404.
82. Gray AC, White TO, Clutton E, et al. The stress response to bilateral femoral fractures: a comparison of primary intramedullary nailing and external fixation. J Orthop Trauma. 2009;23:90-97.
83. Pape HC. Effects of changing strategies of fracture fixation on immunologic changes and systemic complications after multiple trauma: damage control orthopedic surgery. J Orthop Res. 2008;26: 1478-1484.
84. Pape HC, Rixen D, Morley J, et al. Impact of the method of initial stabilization for femoral shaft fractures in patients with multiple injuries at risk for complications (borderline patients). Ann Surg. 2007;246: 491-499.
85. Giannoudis PV, Pape HC, Cohen AP, et al. Review: systemic effects of femoral nailing: from Kuntscher to the immune reactivity era. Clin Orthop Relat Res. 2002;404:378-386.
86. Harwood PJ, Giannoudis PV, van Griensven M, et al. Alterations in the systemic inflammatory response after early total care and damage control procedures for femoral shaft fracture in severely injured patients. J Trauma. 2005;58:446-452.
87. Lehmann U, Rickels E, Krettek C. Multiple trauma with craniocerebral trauma. Early definitive surgical management of long bone fractures? [in German] Unfallchirurg. 2001;104:196-209.
88. Pell AC, Christie J, Keating JF, et al. The detection of fat embolism by transoesophageal echocardiography during reamed intramedullary nailing. A study of 24 patients with femoral and tibial fractures. J Bone Joint Surg Br. 1993;75:921-925.
89. Giannoudis PV, Smith RM, Bellamy MC, et al. Stimulation of the inflammatory system by reamed and unreamed nailing of femoral fractures. An analysis of the second hit. J Bone Joint Surg Br. 1999;81: 356-361.
90. Roberts CS, Pape HC, Jones AL, et al. Damage control orthopaedics: evolving concepts in the treatment of patients who have sustained orthopaedic trauma. Instr Course Lect. 2005;54:447-462.
91. Pape HC, Giannoudis PV, Krettek C, et al. Timing of fixation of major fractures in blunt polytrauma: role of conventional indicators in clinical decision making. J Orthop Trauma. 2005;19:551-562.
92. Taeger G, Ruchholtz S, Waydhas C, et al. Damage control orthopedics in patients with multiple injuries is effective, time saving, and safe. J Trauma. 2005;59:409-416.
93. Nowotarski PJ, Turen CH, Brumback RJ, et al. Conversion of external fixation to intramedullary nailing for fractures of the shaft of the femur in multiply injured patients. J Bone Joint Surg Am. 2000;82:781-788.
94. Scalea TM. Optimal timing of fracture fixation: have we learned anything in the past 20 years? J Trauma. 2008;65:253-260.
95. Rixen D, Grass G, Sauerland S, et al. Evaluation of criteria for temporary external fixation in risk-adapted damage control orthopedic surgery of femur shaft fractures in multiple trauma patients: 'evidence-based medicine' versus 'reality' in the trauma registry of the German Trauma Society. J Trauma. 2005;59:1375-1394.
96. Morshed S, Miclau T 3rd, Bembom O, et al. Delayed internal fixation of femoral shaft fracture reduces mortality among patients with multisystem trauma. J Bone Joint Surg Am. 2009;91:3-13.