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Damage Control Orthopedics · trauma
A borderline polytrauma patient has a femoral shaft fracture, an evolving chest injury, and a climbing lactate. Isolated-femur “early total care” energy in the room is high. The DCO move is: A Reamed antegrade nailing now so the femur is “done” B Spanning external fixation tonight; convert when physiology and soft tissues allow C Skin traction for a week with no skeletal stability D Bilateral retrograde nails to save time Ortho Conditioning
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