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open fracture; compound fracture
Open fractures occur when the fractured bone is open through the skin.
Etiology:
- motor vehicle accidents
- accidental falls
- sports injuries
Radiology:
- plain radiograph to delineate extent of fracture
- computed tomography &/or magnetic resonance imaging as needed to assess osteomyelitis
Complications:
- high-risk of developing osteomyelitis
- non-union of the bone
- problems associated with healing of the fracture
Management:
- analgesia
- urgent surgery in all cases
- empiric antibiotic therapy (NNT=16 [2])
- negative pressure wound therapy of no benefit for patients with severe open fracture of the lower limb [3]
General
bone fracture
References
- Cluett J
Tibia Fracture
http://orthopedics.about.com/cs/brokenbones/g/openfracture.htm
- The NNT: Early Antibiotic Use in Open Fractures.
http://www.thennt.com/nnt/antibiotics-for-open-fractures/
- Gosselin RA, Roberts I, Gillespie WJ
Antibiotics for preventing infection in open limb fractures.
Cochrane Database Syst Rev. 2004;(1):CD003764
PMID: 14974035
- Costa ML, Achten J, Bruce J et al
Effect of Negative Pressure Wound Therapy vs Standard Wound
Management on 12-Month Disability Among Adults With Severe
Open Fracture of the Lower Limb: The WOLLF Randomized Clinical
Trial.
JAMA. 2018; 319(22):2280-2288
PMID: 29896626
https://jamanetwork.com/journals/jama/fullarticle/2684606