INTRODUCTION Open supracondylar femur fractures are rare, complex injuries which occur in polytrauma patients and are complicated by bone loss, contamination, compromised soft tissues, and poor host condition. The purpose of this study is to demonstrate a successful treatment protocol for these challenging injuries. METHODS A consecutive series of 15 open supracondylar femur fractures in 14 p...

BACKGROUND Telemedicine widely takes root in all branches of modern medicine including traumatology and orthopedics. The main goal of this work was to present our experience with asynchronic teleconsultation in daily clinical practice, in particular in the treatment of polytrauma patients. METHODS Throughout 2000 and 2003, we carried out 144 teleconsultations for 92 men and 52 women (age rang...

PURPOSE The purpose of this study was to determine the frequencies of visual impairment and dysfunction among combat-injured Polytrauma Rehabilitation Center (PRC) inpatient and Polytrauma Network Site (PNS) outpatient military personnel with traumatic brain injury (TBI). METHODS A retrospective analysis of data from vision screenings of 68 PRC-inpatients with moderate to severe levels of TBI...

We measured levels of calcitonin and other markers of calcium and phosphorus metabolism in both unconscious and conscious patients after multiple trauma. We found dramatic increases in calcitonin levels in unconscious patients, and smaller increases in conscious patients. In two cases, very high levels, more than 100 x normal, appeared to be related to more rapid healing of bone. Calcitonin lev...

A ppropriate management of a polytrauma patient begins at the scene of the accident. Early initiation of Advanced Trauma Life Support (ATLS) protocols by emergency medical personnel and rapid transport to an appropriate facility is essential to maximize a patient’s chance of survival. Fifty percent of trauma deaths occur within minutes of the accident, usually due to hemorrhage or head injuries...

OBJECTIVE To explore the hypothesis that blood transfusion contributes to an immunosuppressed phenotype in severely injured patients. BACKGROUND Despite trauma patients using disproportionately large quantities of blood and blood products, the immunomodulatory effects of blood transfusion in this group are inadequately described. METHODS A total of 112 ventilated polytrauma patients were re...

Critical care in the U.S. military has significantly evolved in the last decade. More recently, the U.S. military has implemented organizational changes, including the use of multidisciplinary teams in austere environments to improve outcomes in severely injured polytrauma combat patients. Specifically, organizational changes in combat support hospitals located in combat zones during Operation ...