Der Unfallchirurg
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There have been substantial changes in the management of multiply injured patients over the last decades. In the 1950s and 60s, perioperative care was limited and the surgical techniques were not well developed. It was therefore discussed that a patient might be "too sick to operate" and the general recommendation was to postpone surgical care of the extremities,until a patient had stabilized. ⋯ For these patients, the concept of initial temporary fixation and secondary conversion to a definitive procedure has recently been advocated, and the term "damage control orthopaedic surgery" was coined. Within recent years, an increased consensus has occurred across the countries and the oceans in regards to the acceptance of the concept of damage control. This manuscript documents the pathogenetic back grounds and the clinical results leading to a change in the management of orthopaedic injuries towards damage control.