Early osteosynthesis in patients with severe brain injury

Immobilization in a supine position, which is often mandatory with skeletal traction for major fractures, increases intracranial pressure. Positive-pressure ventilation, which is required for acute respiratory distress syndrome, increases intracranial pressure. Forced immobilization may induce or aggravate agitation and restlessness, increasing intracranial pressure. Operative fracture stabilization allows the brain-injured patient to be placed in a semirecumbent position at an early stage, which may help to decrease intracranial pressure. Early fixation also offers the best chance of functional recovery of extremity injuries, particularly if a permanent neurological deficit results.

Several clinical studies have shown a positive effect of early fracture stabilization in preventing secondary brain damage, reducing mortality, and facilitating nursing

(BLert.and..G.o.rjs 1.9.9.5.). Also, the outcome of brain injury was better in patients with early fracture fixation than in a group receiving conservative treatment ( Ho.tm.an...

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