Multidisciplinary Approach to Major Trauma: Changing Strategies and Priorities in Orthopaedic Implantology

The chapter discusses the management of polytrauma patients, who suffer from multiple injuries and have a higher risk of mortality. The approach to the caare of polytrauma patients requires a multidisciplinary team consisting of specialists in anaesthesiology, trauma and orthopaedic surgery, visceral surgery, radiology, neurosurgery and vascular surgery. Communication and team management skills are crucial, and there are educational programmes like Advanced Trauma Life Support (ATLS) to improve the clinical procedures. The multidisciplinary approach starts in the prehospital setting with proper assessment of trauma severity and transfer to a trauma centre if necessary. Polytrauma patients frequently suffer musculoskeletal injuries that need to be evaluated and treated by a trauma or orthopaedic surgeon. The chapter outlines two concepts of treatment for these patients: “early total care” and “damage control orthopaedics”, with the latter being more effective for certain trauma patients with multiple injuries. The chapter also discusses the challenges of assessing trauma severity for decisionmaking between these two concepts.