Open Fracture

Question 1

What is an open fracture?

Answer 1

Direct communication between fracture site and external environment

Question 2

Clinical features of an open fracure

Answer 2

Pain
Swelling
Deformity

Overlying wound

Check full neurovascular status

Question 3

What is the Gustilo-Anderson classification?

Answer 3

Classify open fractures

Type 1 = <1cm wound and clean
Type 2 = 1-10cm wound and clean
Type 3a = >10cm wound and high energy, with adequate soft tissue coverage
Type 3b = >10cm wound and high energy, with inadequate soft tissue coverage
Type 3c = all injuries with vascular injury

Question 4

Investigations for an open fracture

Answer 4

X-ray

Bloods
- include clotting screen and group&save

Question 5

Management of an open fracture

Answer 5

Urgent realignment and splinting

Broad spectrum antibiotics

Tetanus vaccination

Debridemet of wound

• remove all devitalised tissue
• wash out with saline

Question 6

What dressing is used in an open fracture?

Answer 6

Saline soaked dressing

Question 7

Why are antibiotics and tetanus given?

Answer 7

Easy site of infection