ETD

• Damage Control Orthopedics
• Early Total Care
• external fixation
• infections
• LOS
• open fractures
• polytrauma
• road traffic injury
• trauma center

Open fractures in polytrauma patients are a major clinical challenge due to infection risk, soft tissue damage, and long-term disability. Their management requires timely surgery, a multidisciplinary approach, and strict adherence to protocols, yet outcomes remain heterogeneous and difficult to predict. The study aimed to analyze outcomes in polytrauma patients, with particular attention to the use of ETC or DCO, hospitalization burden, ICU admissions, and infectious complications. We conducted a retrospective analysis of 115 patients admitted to AOUP between 2020 and 2023. Data included demographics, trauma dynamics, fracture classification, treatment choices, and clinical outcomes. Of 115 patients, 53 were polytrauma. Median age was 47.1 years; most injuries were due to road traffic accidents and mainly involved the tibia. External fixation was used in 73% of cases. Polytrauma patients had more admissions, longer first stay, and longer total hospitalization compared to non-polytrauma cases. Higher fracture severity correlated with increased length of stay and with a prolonged first hospitalization. External fixation was also associated with longer overall hospitalization, reflecting the greater clinical complexity of these patients. Infectious complications, recorded in 18 cases, were correlated only with fracture severity, not with polytrauma, ICU admission, nor fixation method. External fixation was effective but implied longer stays. Fracture severity emerged as the strongest predictor of outcomes, emphasizing the importance of early, standardized, multidisciplinary care in this high-risk population.