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  • Tolgay Şatana

Trauma and the Skeletal System

Although the concept of trauma is defined as a physical injury that changes the body, it is known to have complex biochemical consequences (see: endocrine response to trauma) in a living organism. The skeletal system provides the first defense in physical interactions with its strong carrier, skull and rib cage-like covering feature. Trauma; Whether blunt, penetrating or post-explosive, the skeletal system acts as a protector. Since injuries that occur in this way are very specific and involve many systems; Concepts and specialties such as trauma center, trauma team, trauma surgeon have developed.

Orthopedics and traumatology specialist works as part of the trauma team in the treatment of skeletal system injuries such as fractures, dislocations and crushes that occur after trauma.

The aim of orthopedic surgery is to remove foreign bodies with injuries resulting from trauma, to repair fractures and to provide body integrity by placing dislocations.

First of all, the vital functions of the patient should be corrected by the trauma team. Joints can be placed during these procedures. In particular, determinations and tractions to immediately remove the pressure and correct the alignment, such as significant alignment disorders that may cause limb loss, such as knee dislocation, and spinal fracture, sometimes have to be performed simultaneously in the ABC rule. For example, a neck fracture may require immediate intervention as it will stop the respiratory center from functioning.

The traumatized patient should be intervened by trained personnel, it is a known fact that unconscious interventions, even with first aid, will cause loss of life.

When the trauma team reaches the area, after the first procedure, “separation=triage”, critical patients undergo immediate resuscitation (resuscitation). Skeletal system problems are carefully evaluated and necessary interventions such as appropriate temporary fixations and stopping bleeding are carried out immediately. Critical dislocations are seated or placed in a safe position, and spinal fractures are carefully identified and prepared for transport. Whether the transport will be carried out by air or by land, it is planned according to the timing of the intervention and the trauma center is warned.

After the patient’s vital functions are preserved and the transfer to the center is completed, the internal organs, thoracic cage and skull injuries are treated immediately and the necessary skeletal structures are determined.

The timing of the treatment of skeletal trauma needs to be “immediate” in modern orthopedic surgery. The aim is to prepare the patient for action and to protect the patient against catastrophic consequences such as fat embolism. Fractures that are detected and treated early will heal better and reduce the strain on other organ systems. Otherwise, the body balance will be disturbed by the metabolic load in the trauma body. The best rehabilitation is immediate treatment.

Skeletal system surgery was performed without creating new wounds as much as possible, which enabled the development of percutaneous surgeries that kept the patient away from new traumas. Today, long bones can be treated with nails embedded in the bone marrow or with plate supports that stay away from the bone. In the near future, fixation materials that dissolve in the body instead of metal, and even bone adhesives will be put into widespread use.

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