{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T11:52:33Z","timestamp":1753357953339},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"1096","license":[{"start":{"date-parts":[[2016,10,11]],"date-time":"2016-10-11T00:00:00Z","timestamp":1476144000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2017,2,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Trauma is one of the leading causes of death worldwide, with road traffic accidents being the leading cause of death in the age group of 15\u201329\u2005years However, with modern advances in management and the introduction of specialised trauma centres, more and more are surviving severe and life-threatening trauma. The ideal timing of fracture fixation has been the subject of debate for a number of decades. There is evidence to suggest that fracture fixation in the patient with polytrauma is best achieved early on to reduce the incidence of morbidity and mortality, with damage control surgery in the more appropriate option in those patients who are haemodynamically unstable. However, early fracture fixation is not always possible, and the focus of this article is to review the common contributing factors resulting in delayed fixation. For the purpose of this discussion, we will consider all trauma as a single entity, taking into account that each type of fixation has its own complications, which are outside the scope of this article.<\/jats:p>","DOI":"10.1136\/postgradmedj-2016-134143","type":"journal-article","created":{"date-parts":[[2016,10,12]],"date-time":"2016-10-12T01:31:13Z","timestamp":1476235873000},"page":"91-95","update-policy":"http:\/\/dx.doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Timing of fracture fixation from an Intensive Care Unit perspective: the obstacles to early fracture fixation"],"prefix":"10.1093","volume":"93","author":[{"given":"Lauren Elizabeth","family":"Thomson","sequence":"first","affiliation":[{"name":"University Hospitals of Coventry and Warwickshire , West Midlands, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Fry","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Jackson","sequence":"additional","affiliation":[{"name":"University Hospitals of Coventry and Warwickshire , West Midlands, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2016,10,11]]},"reference":[{"key":"2023041308091907700_","volume-title":"The global burden of disease","author":"WHO","year":"2004"},{"key":"2023041308091907700_","volume-title":"Injuries and violence: the facts","author":"WHO","year":"2014"},{"key":"2023041308091907700_","first-page":"79","volume-title":"Human Physiology (Jones & Bartlett Learning Titles in Biological Science)","author":"Watson","year":"2014"},{"key":"2023041308091907700_","first-page":"32","volume-title":"A Clinical Guide to the Treatment of the Human Stress Response","author":"Everly","year":"2012"},{"key":"2023041308091907700_","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1016\/j.injury.2004.12.037","article-title":"Pathophysiology of polytrauma","volume":"36","author":"Keel","year":"2005","journal-title":"Injury"},{"key":"2023041308091907700_","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1007\/s00701-005-0651-y","article-title":"A systematic review of brain injury epidemiology in Europe","volume":"148","author":"Tagliaferri","year":"2006","journal-title":"Acta Neurochir (Wien)"},{"key":"2023041308091907700_","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1093\/bja\/ael110","article-title":"Monitoring the injured brain: ICP and CBF","volume":"97","author":"Steiner","year":"2006","journal-title":"Br J Anaesth"},{"key":"2023041308091907700_","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1016\/S0140-6736(00)02689-1","article-title":"Traumatic brain injury","volume":"356","author":"Ghajar","year":"2000","journal-title":"Lancet"},{"key":"2023041308091907700_","first-page":"1352","volume-title":"Handbook of Neurosurgery","author":"Greenberg","year":"2010"},{"key":"2023041308091907700_","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1186\/cc11182","article-title":"Hypertonic saline, not mannitol, should be considered gold-standard medical therapy for intracranial hypertension","volume":"16","author":"Marko","year":"2012","journal-title":"Crit Care"},{"key":"2023041308091907700_","first-page":"6","volume-title":"Neurological and Neurosurgical Intensive Care","author":"Ropper","year":"2003"},{"key":"2023041308091907700_","doi-asserted-by":"crossref","first-page":"1348","DOI":"10.1097\/CCM.0b013e3181d8cf2b","article-title":"Hypocapnia and the injured brain: more harm than benefit","volume":"38","author":"Curley","year":"2010","journal-title":"Crit Care Med."},{"key":"2023041308091907700_","first-page":"15","volume-title":"Emergency Medicine\u2014An International Perspective","author":"T\u00fclin","year":"2012"},{"key":"2023041308091907700_","doi-asserted-by":"crossref","first-page":"759","DOI":"10.2146\/ajhp120203","article-title":"Use of antiepileptics for seizure prophylaxis after traumatic brain injury","volume":"70","author":"Torbic","year":"2013","journal-title":"Am J Health Syst Pharm"},{"key":"2023041308091907700_","doi-asserted-by":"crossref","first-page":"25","DOI":"10.4103\/0974-2700.125635","article-title":"Ventilatory strategies in trauma patients","volume":"7","author":"Arora","year":"2014","journal-title":"J Emerg Trauma Shock"},{"key":"2023041308091907700_","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1093\/bja\/aen362","article-title":"Intensive care\u2014a concise textbook","volume":"102","author":"Webster","year":"2009","journal-title":"Br J Anaesth"},{"key":"2023041308091907700_","first-page":"72","article-title":"Pathophysiology of Respiratory Failure and Indications for Respiratory Support","volume":"21","author":"Gunning","year":"2003","journal-title":"Surgery"},{"key":"2023041308091907700_","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1007\/s001340100955","article-title":"Acute respiratory distress syndrome among trauma patients: trends in ICU mortality, risk factors, complications and resource utilization","volume":"27","author":"Navarrete-Navarro","year":"2001","journal-title":"Intensive Care Med"},{"key":"2023041308091907700_","first-page":"284","volume-title":"AACN protocols for practice: care of mechanically ventilated patients","author":"Burns","year":"2008"},{"key":"2023041308091907700_","doi-asserted-by":"crossref","DOI":"10.1002\/9780470757901","volume-title":"Essential guide to acute care","author":"Cooper","year":"2006"},{"key":"2023041308091907700_","volume-title":"Atrial fibrillation: The management of atrial fibrillation | important-information-about-this-guidance | Guidance and guidelines","author":"NICE","year":"2014"},{"key":"2023041308091907700_","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1186\/cc6136","article-title":"Clinical review: treatment of new-onset atrial fibrillation in medical intensive care patients\u2014a clinical framework","volume":"11","author":"Sleeswijk","year":"2007","journal-title":"Crit Care."},{"key":"2023041308091907700_","first-page":"25","article-title":"Evaluation of stress hormones in traumatic brain injury patients with gastrointestinal bleeding","volume":"13","author":"Alain-Pascal","year":"2010","journal-title":"Chin J Traumatol"},{"key":"2023041308091907700_","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1097\/01.TA.0000135348.48525.A0","article-title":"Practice management guidelines for nutritional support of the trauma patient","volume":"57","author":"Jacobs","year":"2004","journal-title":"J Trauma"},{"key":"2023041308091907700_","first-page":"1791","author":"Ronco","year":"2009","journal-title":"Critical care nephrology"},{"key":"2023041308091907700_","first-page":"600","article-title":"The effects of acidosis and alkalosis on cardiac output and peripheral resistance in humans","volume":"35","author":"Khazel","year":"1969","journal-title":"Americn J Surg"},{"key":"2023041308091907700_","first-page":"S8","article-title":"Sepsis and its complications: the clinical problem","volume":"22","author":"Bone","year":"1994","journal-title":"Crit Care Med"},{"key":"2023041308091907700_","doi-asserted-by":"crossref","first-page":"2234","DOI":"10.1097\/01.CCM.0000145586.23276.0F","article-title":"Epidemiology of sepsis in patients with traumatic injury","volume":"32","author":"Osborn","year":"2004","journal-title":"Crit Care Med"},{"key":"2023041308091907700_","volume-title":"Molecular biology of the cell","author":"Alberts","year":"2002"},{"key":"2023041308091907700_","doi-asserted-by":"crossref","first-page":"1601","DOI":"10.1056\/NEJM199412153312401","article-title":"A prospective study of venous thromboembolism after major trauma","volume":"331","author":"Geerts","year":"1994","journal-title":"N Engl J Med"},{"key":"2023041308091907700_","doi-asserted-by":"crossref","first-page":"1334","DOI":"10.1227\/NEU.0b013e31824d179b","article-title":"Coagulopathy after traumatic brain injury","volume":"70","author":"Laroche","year":"2012","journal-title":"Neurosurgery"},{"issue":"(3)","key":"2023041308091907700_","first-page":"CD008303","article-title":"Thromboprophylaxis for trauma patients","author":"Barrera","year":"2013","journal-title":"Cochrane database Syst Rev"},{"key":"2023041308091907700_","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1055\/s-0030-1254047","article-title":"Disseminated intravascular coagulation in trauma injuries","volume":"36","author":"Lippi","year":"2010","journal-title":"Semin Thromb Hemost"},{"key":"2023041308091907700_","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1097\/SLA.0b013e31821221b1","article-title":"Trauma, shock, and disseminated intravascular coagulation: lessons from the classical literature","volume":"254","author":"Gando","year":"2011","journal-title":"Ann Surg"},{"issue":"5","key":"2023041308091907700_","first-page":"S203","article-title":"Modeling the two-hit hypothesis for evaluating strategies to prevent organ injury after shock\/resuscitation","volume":"54","author":"Rotstein","year":"2003","journal-title":"J Trauma"},{"key":"2023041308091907700_","first-page":"103","article-title":"Damage control orthopedics\u2014when and why","volume":"2","author":"James","year":"2007","journal-title":"J Lancaster Gen Hosp"},{"key":"2023041308091907700_","first-page":"124","article-title":"Fracture fixation in patients having multiple injuries","volume":"46","author":"O'Brien","year":"2003","journal-title":"Can J Surg"},{"key":"2023041308091907700_","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1097\/00005131-200603000-00004","article-title":"The risk of local infective complications after damage control procedures for femoral shaft fracture","volume":"20","author":"Harwood","year":"2006","journal-title":"J Orthop Trauma"}],"container-title":["Postgraduate Medical Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/93\/1096\/91\/49839376\/postgradmedj-93-91.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/93\/1096\/91\/49839376\/postgradmedj-93-91.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,20]],"date-time":"2023-08-20T11:56:13Z","timestamp":1692532573000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/pmj\/article\/93\/1096\/91\/6984196"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,10,11]]},"references-count":38,"journal-issue":{"issue":"1096","published-online":{"date-parts":[[2016,10,11]]},"published-print":{"date-parts":[[2017,2,1]]}},"URL":"https:\/\/doi.org\/10.1136\/postgradmedj-2016-134143","relation":{},"ISSN":["1469-0756","0032-5473"],"issn-type":[{"value":"1469-0756","type":"electronic"},{"value":"0032-5473","type":"print"}],"subject":[],"published-other":{"date-parts":[[2017,2]]},"published":{"date-parts":[[2016,10,11]]}}}