open fractures Flashcards

1
Q

What is an open fracture

A

Fracture where there is a direct communication between the fracture and the external environment

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2
Q

Which bones are most commonly involved in open fractures

A

Fingers and tibial shaft

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3
Q

Describe the gustilo classification

A

As you go from type 1-3 - the open fracture becomes more severe

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4
Q

What is the management of open fractures

A

ATLS assessment - ABCDE

Tetanus and antibiotic prophylaxis

Debridement

Cover wound with saline swabs

Surgical emergency surgery for open fractures - usually within 24 hours unless there are specific complications

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5
Q

What is the antibiotic prophylaxis given for open fractures

A

Cefuroximen
Augmentin
Clindamycin

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6
Q

What are the conditions that indicate emergency within <6 hours surgery (6 hour rule) for open fractures

A

Polytraumatised patient
Marine or farmyard environment
gross contamination
Neurovascular compromise
Compartment syndrome

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7
Q

What is debridement

A

removal of dead tissue

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8
Q

What is the criteria to differentiate dead tissue

A

4 C’s

Colour

Contraction - if muscle

Consistency

Capacity to bleed

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9
Q

What conditions lead to the decision of amputation

A

Loss of sensation in the limb

irretrievable soft tissue or bone damage

other life threatening injuries

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