Application of damage control orthopaedics in treatment of massive hemorrhage in severe traumatic fractures

Abstract

This study is designed to investigate the clinical application value of the damage control orthopaedics (DCO) concept in guiding the treatment of severe traumatic fractures with massive hemorrhage. Using the introduction of the DCO concept in the hospital in June 2021 as the cut-off point, patients with severe traumatic fractures and major bleeding admitted in the two periods before the introduction of the DCO concept (January 2021~May 2021) and after the introduction of the DCO concept (June 2021~January 2022) were included as control group (n = 39) and observation group (n = 39), respectively. The control group was given conventional surgery and treatment, whereas the DCO group received treatment and surgery under the guidance of the DCO concept. The results of the intervention were compared between the two groups. The time from admission to definitive surgery was longer in the DCO group than that in the control group. Fewer suspended red blood cells, fresh frozen plasma and platelets were used in the DCO group compared to the control group. The total hospital stay was shorter and the rates of postoperative complications and mortality were lower in the DCO group than those in the control group. Patients were followed up for 6–8 months, with an average of (6.87 ± 1.15) months, and the results showed that the fracture healing rate in DCO group was higher than that in the control group. The concept of DCO could correctly guide the treatment of severe traumatic fractures complicated by massive hemorrhage, and improve the therapeutic safety, reduce the incidence of postoperative complications and mortality, and enhance the later fracture healing rate of patients.