Unfortunately, in the orthopaedic trauma literature, there is an over
emphasis on the severity of the anatomic injury rather than on the
patient’s acute physiology, which should be the main factor to consider
when deciding between DCO and ETC. The European Polytrauma
Study on Management of Femur Fractures aimed to clarify
the situation with a prospective, randomized interventional trial
carried out in 10 level-1 trauma centres.5 The study illustrated the
clear advantage of ETC among stable patients in terms of shorter
ICU stay and less time on the ventilator