Indications and interventions of damage control orthopedic surgeries: an expert opinion survey

Roman Pfeifer, Yannik Kalbas, Raul Coimbra, Luke Leenen, Radko Komadina, Frank Hildebrand, Sascha Halvachizadeh, Meraj Akhtar, Ruben Peralta, Luka Fattori, Diego Mariani, Rebecca Maria Hasler, Rolf Lefering, Ingo Marzi, François Pitance, Georg Osterhoff, Gershon Volpin, Yoram Weil, Klaus Wendt, Hans Christoph Pape

Research output: Contribution to journalArticlepeer-review


Objectives: The objectives of this study were to gather an expert opinion survey and to evaluate the suitability of summarized indications and interventions for DCO. Background: The indications to perform temporary surgery in musculoskeletal injuries may vary during the hospitalization and have not been defined. We performed a literature review and an expert opinion survey about the indications for damage control orthopaedics (DCO). Methods: Part I: A literature review was performed on the basis of the PubMed library search. Publications were screened for damage control interventions in the following anatomic regions: “Spine”, “Pelvis”, “Extremities” and “Soft Tissues”. A standardized questionnaire was developed including a list of damage control interventions and associated indications. Part II: Development of the expert opinion survey: experienced trauma and orthopaedic surgeons participated in the consensus process. Results: Part I: A total of 646 references were obtained on the basis of the MeSH terms search. 74 manuscripts were included. Part II: Twelve experts in the field of polytrauma management met at three consensus meetings. We identified 12 interventions and 79 indications for DCO. In spinal trauma, percutaneous interventions were determined beneficial. Traction was considered harmful. For isolated injuries, a new terminology should be used: “MusculoSkeletal Temporary Surgery”. Conclusion: This review demonstrates a detailed description of the management consensus for abbreviated musculoskeletal surgeries. It was consented that early fixation is crucial for all major fractures, and certain indications for DCO were dropped. Authors propose a distinct terminology to separate local (MuST surgery) versus systemic (polytrauma: DCO) scenarios.

Original languageEnglish
Pages (from-to)2081-2092
Number of pages12
JournalEuropean Journal of Trauma and Emergency Surgery
Issue number6
StatePublished - Dec 2021
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2020, Springer-Verlag GmbH Germany, part of Springer Nature.


  • Damage control surgery
  • Extremity
  • Indication
  • Intervention
  • MuST surgery
  • Polytrauma
  • Soft tissues

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine
  • Orthopedics and Sports Medicine
  • Critical Care and Intensive Care Medicine


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