Timing of long bone fracture fixation in severe traumatic brain injury
Jamjoom, B.A.; Jamjoom, A.B.
Neurosciences 17(2): 111-114
2012
ISSN/ISBN: 1319-6138 PMID: 22465883 Document Number: 657948
We present a review of the published evidence on the optimal timing for long bone fracture fixation in severe traumatic brain injury (TBI); a matter that remains under debate. Fifteen retrospective articles (level II-3 evidence) were considered suitable for the review. We conclude that the published evidence does not provide a definitive answer to the optimal timing of long bone fracture surgery in severe TBI, and a randomized controlled trial is required. We recommend a safe strategy that combines damage control surgery with a period of monitoring of intracranial pressure, cerebral perfusion pressure, and if available brain tissue oxygen until the patient is considered fit for the fracture fixation.