Complex Trauma Limb Salvage & Reconstruction

Open Fracture Management

 

OVERVIEW

Open fractures (compound fractures) occur when the bone pierces through the skin. This exposes the fracture to the external environment.

OPEN FRACTURE MANAGEMENT

  1. Debridement and irrigation. Wound debridement and irrigation are part of the initial steps in open fracture management. These techniques are meticulously implemented to remove all contaminated or devitalized tissue or bone.
  2. Skeletal Stabilization
    1. Internal fixation is a technique that involves the insertion of hardware such as screws, nails, and plates within or on the surface of the broken bone. This plays a crucial role in stabilizing and reinforcing the bone during the healing process. These implants provide the necessary support, allowing the fracture to heal.
    2. External or circular fixation. This treatment option involves the careful placement of pins or wires through the skin into the bone to stabilize the fracture Circular fixators are an extremely useful fixation method in open fractures due to their low risk of infection and versatility.
  3. Antibiotics: Early intravenous antibiotic treatment is initiated to prevent infection.
  4. Soft tissue reconstructions: Occasionally, the skin and muscles are so badly injured that they cannot be sutured closed. In such instances, a plastic surgeon is consulted to assist with flaps to cover the exposed bone.

FREQUENTLY ASKED QUESTIONS

1How do you manage more complex wounds?
The treatment plan for wounds, particularly open fractures and serious wounds with extensive skin and muscle tissue loss, depends on our ability to close the wound primarily or not. In cases where the wounds are not closeable, a plastic surgeon is consulted to assist with early flap coverage.
2Are open fractures extremely painful?
Yes, fractures, in general, are incredibly painful and distressing to patients.
3How long does it take to recover completely from an open fracture?
3. The recovery for open fractures depends on the site and severity of the fracture and can range from several weeks to months in some cases.