In the maximum number of cases, open fractures are known to be more serious than closed fractures. Open fractures occur with wounds surrounding the fractured bone along with soft-tissue injury. They deliver the common presentation to A & E (Accident & Emergency). These conditions require quick assessment and management by the team of orthopedics.
Also known as compound fractures, open fractures are caused by high-energy trauma like automobile collisions or even sometimes due to falling from a great height. In the case of open fractures, skin also gets damaged while resulting in soft-tissue injury. There are also certain complications associated with open fractures including malunion, nonunion, and infection.
The treatment of open fractures will depend upon the severity of the condition but it is most commonly done using orthopedic implants like Locking Plate, Antegrade Interlocking Nail, PFNA Nail, Interlocking Nail Femur, and External Fixator System.
Causes of Open Fractures
Open fractures most commonly occur due to high-impact trauma including car accidents and falling from a height. Depending upon the nature of the injury, open fractures could occur in different ways:
Common Fracture
This type of fracture occurs due to different types of forces direct blow, angular forces, axial loading, and torque.
Pathological Fracture
This is the condition that occurs when trauma affects the diseased bone. In such a case, even a minor traumatic injury could result in an open fracture.
Fracture-Dislocations
This is the case where dislocation and fracture both occur simultaneously.
Gunshot Wounds
Gunshot wounds result in damage to the soft tissue along with the fracture to the bone.
Diagnosis of Open Fractures
The goal of diagnosis of open fractures is to strike-out any life-threatening injuries at first. Open fractures are generally serious, thus, they require emergency treatment.
A quick X-ray examination is done when the patient enters the hospital to analyze the fractures that occurred due to trauma. This will give surgeons an idea of the type of surgery required to be done along with the Trauma Implants that need to be used.
Orthopedic injuries are generally evaluated after stabilizing the patient and getting him/her out of the danger.
Management of Open Fractures
The first line of management in the case of open fractures is urgent interventions to bring the patient out of any life-threatening injuries. Besides this, acute management including wound debridement and therapeutic irrigation is done to minimize the chances of infection by cleaning the injured area.
Another way to manage open fractures is with the administration of antibiotics. This is also done to reduce the risk of infection. Antibiotics given are known to provide protection against both gram-negative and gram-positive bacteria.
Open fractures also often require surgical fixation with the use of orthopedic implants. Surgery is known to assist in the healing of wounds and fractured bones. In the case of surgery, use of External Fixation Device, Cannulated Compression Screw, and Titanium Orthopedic Screws. The decision of whether internal fixation will be better or external fixation will be taken by the surgeon depending upon the severity and condition of the fracture.
