{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:49:45Z","timestamp":1790704185579,"version":"4.1.0"},"reference-count":47,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2023,5,31]],"date-time":"2023-05-31T00:00:00Z","timestamp":1685491200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"e Interdisciplinary Center for Clinical Research (IZKF) W\u00fcrzburg","award":["Z-3\/69"],"award-info":[{"award-number":["Z-3\/69"]}]},{"name":"e Interdisciplinary Center for Clinical Research (IZKF) W\u00fcrzburg","award":["HB22PAUL"],"award-info":[{"award-number":["HB22PAUL"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Traumatic brain injury (TBI) is the leading cause of death and disability in polytrauma and is often accompanied by concomitant injuries. We conducted a retrospective matched-pair analysis of data from a 10-year period from the multicenter database TraumaRegister DGU\u00ae to analyze the impact of a concomitant femoral fracture on the outcome of TBI patients. A total of 4508 patients with moderate to critical TBI were included and matched by severity of TBI, American Society of Anesthesiologists (ASA) risk classification, initial Glasgow Coma Scale (GCS), age, and sex. Patients who suffered combined TBI and femoral fracture showed increased mortality and worse outcome at the time of discharge, a higher chance of multi-organ failure, and a rate of neurosurgical intervention. Especially those with moderate TBI showed enhanced in-hospital mortality when presenting with a concomitant femoral fracture (p = 0.037). The choice of fracture treatment (damage control orthopedics vs. early total care) did not impact mortality. In summary, patients with combined TBI and femoral fracture have higher mortality, more in-hospital complications, an increased need for neurosurgical intervention, and inferior outcome compared to patients with TBI solely. More investigations are needed to decipher the pathophysiological consequences of a long-bone fracture on the outcome after TBI.<\/jats:p>","DOI":"10.3390\/jcm12113802","type":"journal-article","created":{"date-parts":[[2023,6,1]],"date-time":"2023-06-01T02:12:45Z","timestamp":1685585565000},"page":"3802","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Impact of a Femoral Fracture on Outcome after Traumatic Brain Injury\u2014A Matched-Pair Analysis of the TraumaRegister DGU\u00ae"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8205-160X","authenticated-orcid":false,"given":"Mila M.","family":"Paul","sequence":"first","affiliation":[{"name":"Department of Orthopedic Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital of W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"},{"name":"Department of Neurophysiology, Institute for Physiology, Julius-Maximilians-University W\u00fcrzburg, 97070 W\u00fcrzburg, Germany"},{"name":"Department of Neurosurgery, University Hospital of W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah J.","family":"Mieden","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital of W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rolf","family":"Lefering","sequence":"additional","affiliation":[{"name":"Institute for Research in Operative Medicine (IFOM), University of Witten\/Herdecke, 51109 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva K.","family":"Kupczyk","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital of W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin C.","family":"Jordan","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital of W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Gilbert","sequence":"additional","affiliation":[{"name":"LMU Klinikum Campus Innenstadt, University of M\u00fcnchen, 80336 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rainer H.","family":"Meffert","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital of W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2217-0081","authenticated-orcid":false,"given":"Anna-Leena","family":"Sir\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Neurophysiology, Institute for Physiology, Julius-Maximilians-University W\u00fcrzburg, 97070 W\u00fcrzburg, Germany"},{"name":"Department of Neurosurgery, University Hospital of W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie","family":"Hoelscher-Doht","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital of W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1637","DOI":"10.1016\/j.apmr.2010.05.017","article-title":"Demographics and Clinical Assessment Working Group of the International and Interagency Initiative toward Common Data Elements for Research on Traumatic Brain Injury and Psychological Health. 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