Open Fractures

Abstract

If the skin is broken in the same anatomic region as the broken bone then the fracture is considered open or compound. If the skin is intact the fracture is considered closed. There are several mechanisms by which fractures become open. Forces may act from outside-in or from inside-out to create these injuries. Open fractures represent a wide array of skeletal injuries and a wide spectrum of soft tissue injury present unique challenges to the treating surgeon. The major problem with open fractures is that they may become infected. The associated soft-tissue injury may also cause delayed union, stiffness, and other problems. Treatment options for open fractures depend on two major factors: the soft tissue problem and the skeletal problem.

The pathophysiology and clinical presentation of open fractures is reviewed and considerations for surgical management are reviewed. This article reviews in detail debridement, soft-tissue, and antibiotic control.

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