In polytrauma patients (ISS > 16) early long bone and pelvic fracture fixation (< 24 hours post injury) has been shown to be beneficial. Surgery in the presence of subclinical hypo perfusion (SCH) (normal vital signs with a serum lactate > 2.5 mmol/L) may be detrimental. This study aimed to investigate the effect of fracture fixation in polytrauma patients with SCH. We performed a retrospective database review of polytrauma patients (ISS > 16) with significant long bone or pelvic fractures (extremity NISS> 9) who underwent surgical fracture stabilisation within 48 hours of injury. In the group of patients with normal vital signs (mean arterial pressure (MAP) > 60 mmHg and heart rate (HR) < 110 beats/min) we compared outcomes of those with normal lactate (< 2.5 mmol/L) prior to surgery with patients that had a raised lactate (> 2.5 mmol/L).Purpose of study:
Description of methods:
