open fracture; compound fracture
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Introduction
Open fractures occur when the fractured bone is open through the skin.
Etiology
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]
More general terms
References
- ↑ Cluett J Tibia Fracture http://orthopedics.about.com/cs/brokenbones/g/openfracture.htm
- ↑ 2.0 2.1 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: https://www.ncbi.nlm.nih.gov/pubmed/14974035 - ↑ 3.0 3.1 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: https://www.ncbi.nlm.nih.gov/pubmed/29896626 https://jamanetwork.com/journals/jama/fullarticle/2684606