KUMJ | VOL. 24 | NO. 2 | ISSUE 95 | APRIL - JUNE, 2026

Successful Implementation of Early Total Care in Polytrauma
Dahal A, Chaudhary A, Basi A, Chaudhary A, Bhusal S, Shrestha R

Abstract:
Polytrauma management demands a precise balance between early physiological stabilization and definitive anatomical restoration. While damage control orthopedics (DCO) uses a staged approach to avoid physiological overload, it can increase hospital stay and risks like infection, joint stiffness and muscle contractures. Early total care (ETC) involves the definitive fixation of all injuries in a single surgical setting. We present a case of a 27-year-old male who sustained polytrauma following a road traffic accident under the influence of alcohol. Following successful initial resuscitation by an interdisciplinary team of emergency physicians, surgeons, and anesthesiologists, the patient underwent early total care incorporating dynamic hip screw fixation, interlocking nailing, Ilizarov fixation, and pinning. The management results in an uneventful intraoperative and postoperative course. This case highlights that with rigorous multidisciplinary resuscitation and precise patient selection, single-stage early total care remains a safe, highly effective strategy to optimize early outcomes and streamline recovery in complex polytrauma.
Keyword : Damage control orthopedics, Early total care, Polytrauma, Trauma