Controversy and Actual State of Surgical Strategies for the Management of Major Trauma and Multiple Members Injuries

The optimal treatment of major trauma and multiple injuries continues to be discussed. Advances in resuscitation and surgical techniques have been the principal criteria for surgical decision-making, these last five decades. The evolution of the treatment shows four great successive strategies, mainly for the management of long bone fractures: the delayed treatment, the early total care (ETC), the trauma damage control orthopaedic (TDCO) and the early appropriate care (EAC). The EAC appears as the latest strategy, beyond the debate between ETC and TDCO.