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Gãy xương cực là phổ biến ở bệnh nhân chấn thương não sau chấn thương (Tbis). Chấn thương là luận án thường được điều trị và đôi khi là không đầy đủ hoàn toàn bỏ qua do các vấn đề độc đáo vốn có cho các bệnh nhân TBI. Tuy nhiên, đánh giá thích hợp của bệnh nhân và cho phép chẩn đoán | Extremity Fractures in the Patient With a Traumatic Brain Injury Vivek P. Kushwaha MD and Douglas G. Garland MD Abstract Extremity fractures are common in patients with traumatic brain injuries TBIs . These injuries are often inadequately treated and occasionally are completely missed due to the unique problems inherent to the TBI patient. However appropriate evaluation of the TBI patient allows prompt diagnosis and optimal treatment of extremity fractures. The increased survival rate of these patients has resulted in a greater emphasis on minimizing dysfunction and disability especially that due to concomitant orthopaedic trauma. Advances in anesthestic technique permit earlier operative fixation of extremity fractures. Most injuries particularly those in the lower extremity require operative stabilization to allow early mobilization and rehabilitation. Upper extremity fractures are often associated with peripheral nerve injuries. Heterotopic ossification is common especially about the elbow and hip. Contrary to prevalent belief fracture healing is not necessarily accelerated in the TBI patient hypertrophic callus myositis ossificans and heterotopic ossification occur frequently and are often misperceived as accelerated healing. J Am Acad Orthop Surg 1998 6 298-307 The probability that a patient with a traumatic brain injury TBI will survive the injury has increased dramatically in recent years. Advances in emergency care and the establishment of trauma centers and specialized intensive care units have improved the overall rate of survival of these patients. Extremity injuries are present in 40 to 60 of head-injured patients.1-3 Approximately 80 000 head-injured patients survive every year in the United States with a considerable portion having some disability as a sequela of an orthopaedic injury.4 Minimizing disability is especially important because most survivors are young males with many years of potential productivity. Optimizing the orthopaedic care of .
