Priority 13 from the Complex Fractures PSP

UNCERTAINTY: In patients with multiple injuries, which fractures need fixing and when? (JLA PSP Priority 13)
Overall ranking 13
JLA question ID 0105/13
Explanatory note Relatively little is known about which injuries are best treated with early vs late fixaiton and how patient and injury factors influence this. 
Evidence

NICE offer no specific guidance on this uncertainty. A randomised controlled trial has been conducted looking at this question in femoral shaft fractures in multiply injured patients. More broadly this question remains an uncertainty.

No other relevant trial evidence Cochrane/PUBMED since 2015.

Randomized, controlled, two-arm, interventional, multicenter study on risk-adapted damage control orthopedic surgery of femur shaft fractures in multiple-trauma patients
Health Research Classification System category Injuries and accidents
Extra information provided by this PSP
Original uncertainty examples how can we deal with fractures of the multiple bones ~ Should you fix clavicle fractures in polytrauma involving lower limbs
Submitted by  2 x Surgeon/Doctor
PSP information
PSP unique ID 0105
PSP name Complex Fractures
Total number of uncertainties identified by this PSP. 58  (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 8th June 2021