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Orthopedic Trauma in Polytraumatized Patients: Current Management Concepts and Innovations
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Orthopedic Trauma in Polytraumatized Patients: Current Management Concepts and Innovations

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: 30 August 2025 | Viewed by 417

Special Issue Editor

Prof. Dr. Thomas Lustenberger

E-Mail Website
Guest Editor
Department of Orthopedic Surgery and Traumatology, Inselspital, Freiburgstrasse 18, 3010 Bern, Switzerland
Interests: polytrauma management; management of pelvic fractures; posttraumatic coagulopathy; geriatric fractures
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Orthopedic trauma plays a critical role in the polytrauma setting, as it is often one of the most common and significant components in severely injured patients. The management of these injuries is based on a multidisciplinary approach, including appropriate prioritization of care, early assessment and imaging, and timely, adapted fracture stabilization, all while considering the patient’s clinical condition. The goal of managing orthopedic injuries in these situations is to balance the need for early skeletal stabilization with the long-term goal of functional recovery, incorporating both traditional principles and innovative technologies to improve patient outcomes.

This Special Issue focuses on current concepts in orthopedic management within the context of polytrauma, emphasizing the importance of multidisciplinary collaboration among orthopedic surgeons, trauma surgeons, anesthetists, intensivists, and rehabilitation specialists. Innovations in treatment—such as minimally invasive techniques to reduce additional soft tissue damage, biologic agents to promote bone healing, and navigation methods for precise fracture reconstruction, just to name a few—will likewise be addressed. We look forward to your valuable submissions.

Prof. Dr. Thomas Lustenberger
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • polytrauma
  • geriatric polytrauma
  • fracture management
  • fracture stabilization
  • damage control orthopedics
  • early appropriate care
  • multidisciplinary approach
  • innovations
  • minimally invasive surgery

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Published Papers (1 paper)

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Research

11 pages, 1101 KiB  
Article
Short- and Long-Term Mortality in Severely Injured Older Trauma Patients: A Retrospective Analysis
by Silviya Ivanova, Elsa F. Hilverdink, Johannes D. Bastian, Dominik A. Jakob, Aristomenis K. Exadaktylos, Marius J. B. Keel, Joerg C. Schefold, Helen Anwander and Thomas Lustenberger
J. Clin. Med. 2025, 14(6), 2064; https://doi.org/10.3390/jcm14062064 - 18 Mar 2025
Viewed by 270
Abstract
Background/Objectives: Older trauma patients experience increased in-hospital mortality due to the physiological challenges associated with aging and injury severity. However, limited data exist on long-term mortality rates beyond hospital discharge, particularly among severely injured elderly trauma patients. Understanding these outcomes is essential [...] Read more.
Background/Objectives: Older trauma patients experience increased in-hospital mortality due to the physiological challenges associated with aging and injury severity. However, limited data exist on long-term mortality rates beyond hospital discharge, particularly among severely injured elderly trauma patients. Understanding these outcomes is essential for improving clinical management and rehabilitation strategies. The objective of this study was to evaluate cumulative mortality rates (in-hospital, 28-day, 1-year, 2-year, and 3-year) in older trauma patients with an Injury Severity Score (ISS) ≥ 16. Independent risk factors for 1-year mortality were also identified. Methods: This retrospective cohort study included all trauma patients aged ≥ 65 years with ISS ≥ 16 admitted to the Emergency Department of our level 1 trauma center between January 2017 and December 2022. Demographic characteristics, injury patterns (Abbreviated Injury Scale (AIS) scores, ISS), and mortality rates were collected from electronic health records. Patients were stratified into two age groups: 65–80 years and >80 years. Mortality rates were compared with those in the corresponding age groups in the general Swiss population. Statistical analysis included Kaplan–Meier survival curves and logistic regression for identifying risk factors associated with 1-year mortality. Results: A total of 1189 older trauma patients with a mean ISS of 24.3 ± 7.9 were included. The most common injury was severe head trauma (AIS head ≥ 3: 70.6%), followed by chest trauma (AIS chest ≥ 3: 28.2%) and extremity injuries (AIS extremity ≥ 3: 17.4%). The overall in-hospital mortality rate was 10.3%. Mortality rates at 28 days, 1 year, 2 years, and 3 years were 15.8%, 26.5%, 31.5%, and 36.3%, respectively. Age-stratified analysis showed significantly higher mortality rates in patients aged > 80 years compared to the 65- to 80-year group at all post-discharge time points (28-day: 22.6% vs. 11.9%, p < 0.001; 1-year: 39.9% vs. 18.8%, p < 0.001; 2-year: 46.5% vs. 22.8%, p < 0.001; 3-year: 56.4% vs. 24.9%, p < 0.001). Compared to the general Swiss population, we observed significantly higher mortality rates at all measured time points in elderly trauma patients, particularly in those aged over 80 years, with 1-year mortality rates of 39.9% vs. 10% in the general population and 3-year mortality rates of 56.4% vs. 30% in the general population. Independent risk factors for 1-year mortality included advanced age and severe head injury (AIS head ≥ 3, p < 0.001). Conclusions: Severely injured elderly trauma patients face high long-term mortality risks, with 1-year mortality rates reaching 26.5% overall and nearly 40% in patients aged > 80 years. These findings highlight the need for research on tailored, holistic management strategies, including comprehensive in-hospital care, specialized neurorehabilitation, and post-discharge follow-up programs to improve survival and functional recovery in this vulnerable population. Full article
(This article belongs to the Special Issue Orthopedic Trauma in Polytraumatized Patients: Current Management Concepts and Innovations)
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