· ALL pelvic and acetabular fractures
are treated at UKHeathCare.
· Long bone fractures, isolated or
multiply injured, are taken to the operating room for initial or definitive
fixation within 24 hours of presentation to UKHealthCare unless not medically
cleared by the primary team. Refer to “Determining Extent of Orthopaedic
Intervention in Acute Multi-System Trauma” for damage control priorities.
· Open fractures are taken to operating
room for surgical irrigation & debridement within 24 hours of presentation
to UKHealthCare. Initial washout at bedside will be performed when appropriate.
Refer to “Determining Extent of Orthopaedic Intervention in Acute Multi-System
Trauma” for priorities of care in the multi-injured patient.
· Open fractures receive the first dose
of antibiotics within 60 minutes of arrival at UKHealthCare. See “Antibiotic
and Tetanus in Open Fractures Guideline” for identification of appropriate
antibiotics and dosage.
· Supracondylar humerus fractures,
Gartland type III or greater, are taken for repair at least 18 hours from time of
injury.
The
Orthopaedic team provides immediate consultation in a time-sensitive response (30 minutes) when requested by the surgical
team leader for multiply injured patients with time-sensitive injuries:
- fractures with neurovascular compromise
- pelvis fractures with hemodynamic instability
- joint dislocations
- Suspected compartment syndrome
- Pulseless extremity
Response times are tracked in the PIPS program.
