Kuhmola A, Simons T, Handolin L, et al. - In this study, the surgical treatment strategy (Early Definitive Care (EDC) or Damage Control Orthopaedics (DCO)) implemented in the care of severely injured patients with femoral shaft fractures treated at a single tertiary trauma centre in southern Finland and factors affecting decision making was explored. Researchers retrospectively applied Helsinki Trauma Registry to distinguish severely injured patients (New Injury Severity Score ≥ 16) treated from 2006 through to 2018 with concomitant femoral shaft fractures. They classified femoral fracture patients into EDC and DCO groups. In severely injured femoral shaft fracture patients treated at a tertiary trauma centre, results revealed early definitive care as the prevailing treatment strategy. As per the outcomes, individuals treated with DCO strategy are more severely injured especially having sustained worse intracranial and thoracic injuries. The findings demonstrated that in addition to injury-related factors, treatment strategy decision making was affected by non-injury related factors in only a minority of cases.