Background and Objectives: Damage control orthopaedics (DCO) seeks to minimize surgical impact while treating all long bone and pelvic fractures in an emergency basis. Temporary external fixation is the preferred method for DCO in polytrauma care and mass casualty events.. External fixation allows stabilisation of long bone fractures without prolonged surgical procedures; reduce blood loss and systemic inflammatory response, although it is not clear which is the effect on complications and mortality.

Materials and Methods: Case series. Retrospective analysis of data trauma registry data. We studied the clinical outcome of a consecutive group of by DCO concepts for long bone and pelvic fractures, including a mass casualty event with multiple victims from a bomb attack. We analyzed the clinical outcomes in terms of systemic complications and mortality measured by TRISS methodology.

Inclusion criteria: Age > 15, ISS> 16, external fixation in first 6 hours for long bone or pelvic fractures

Results: Between 2003 and 2008 45 patients met the inclusion criteria. Average age was 33 yrs, means ISS 35, and most patients suffered road traffic accidents. We performed 65 temporary external fixators in forty five patients. Most frequent procedures were femur external fixation in 30 cases followed by tibia external fixation in 25 patients. Systemic complication rate was high. Six patients died. We found a reduction in mortality between probability of survival by TRISS and real mortality of 0.18 (0, 67 Ps versus 0, 85 real survival)

Conclusions: External fixation for early fixation of long bone fractures in polytrauma patient is a safe and successful treatment. DCO seems to reduce mortality in severe polytrauma patients with multiple fractures.

Introduction and Objectives: Lesions due to falls cause a combination of skeletal lesions that require specific treatment. The aim of this study is to determine the epidemiological and evolutionary profile of a group of patients with severe trauma due to falls.

Materials and Methods: We carried out an analysis of the register of the Hospital Trauma Service. The variables we studied were: demographic; scores: the Injury Severity Score (ISS), the New Injury Severity Score (NISS), the Revised Trauma Score (RTS); probability of survival, type of lesion and evolution data.

Results: Between 2003 and 2008, 190 patients were admitted due to falls. Mean age was 39 years. And 85.3% were men, 100% of the falls were at work and 62% were suicide attempts. Mean ISS: 27.3; mean NISS: 34.1. The severity expressed by ISS and NISS was higher in the group of patients that had suffered falls than in those with lesions due to other causes. Mean probability of survival was 81%, 65% for suicide attempts. The main causes of falls were work-related 40%, accidental 24.7% and attempted suicide 22%. There was a greater incidence of attempted suicides in women and foreigners. The mean height of the falls was 9.7 m. The most frequently affected bone was the tibia, with 56 fractures. There were 51 pelvis fractures. The most frequent combined lesion was lesion of the pelvic bone together with a lesion of a long bone of the leg, 13 cases. Global mortality was 14.2%, with 17.1% in the worker group and 21% in the suicide group.

Discussion and Conclusions: In our environment there is a high rate of lesions due to falls. The severity of the lesions scored by ISS and NISS is greater than for lesions due to other causes that are not falls.