Skip to main content
. Author manuscript; available in PMC: 2009 Apr 30.
Published in final edited form as: J Am Acad Orthop Surg. 2009 Apr;17(4):255–265. doi: 10.5435/00124635-200904000-00006

Table 1.

Criteria for Treatment of Fractures in Trauma Patients

Requirements for Clinical Status of Patients With Multiple Trauma Prior to
 Surgical Fixation
No evidence of increasing infiltration of lung parenchyma on chest radiograph (48 hr
 before surgery)
Balanced or negative fluid balance (48 hr before surgery)
PaO2/FiO2 >250 mm Hg within previous 24 hr
Pulmonary artery pressure <24 mm Hg
Peak inspiratory pressure <35 cm H2O
Platelet count >95,000/mm3
Leukocyte count >2,000/mm3 and <12,000/mm3 with no signs of sepsis
Intracranial pressure 15 cm H2O
Computed tomography scan of the head stabilized with no increasing hygroma
 formation
Conditions for Which Fracture Treatment Should Be Limited
Severe head injury with a Glasgow Coma Scale score <8
Severe thoracic trauma/lung contusion with continuous intrabronchial bleeding or
 edema formation
Myocardial infarction
Significant clotting problems
Significant hypothermia (<32°C)

Adapted with permission from Tscherne H, Regel G, Pape HC, Pohlemann T, Krettek C: Internal fixation of multiple fractures in patients with polytrauma. Clin Orthop Relat Res 1998;347:62-78.