In a patient with polytrauma who has a Schatzker type-6 tibial plateau fracture, damage control orthopaedic management of this fracture should include which of the following?
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- Open reduction and internal fixation Immediate open reduction and internal fixation may compromise the patient’s overall outcome if performed before the patient is stabilized by placing the patient at risk for hypothermia, acidosis, and coagulopathy.
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- Intramedullary nailing Intramedullary nailing, if needed, is considered definitive management and should be delayed in damage control orthopaedics. It is not the definitive treatment of choice for tibial plateau fractures.
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- No immobilization Immobilization is needed to help stabilize the patient’s injuries, restoring alignment and stability until definitive management can take place
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- Knee-spanning external fixator A knee-spanning external fixator to correct the fracture deformity and shortening until the patient is stabilized and definitive management can be performed.