Open Fractures Flashcards
What is a open fracture
A fracture is ‘open’ when there is a direct communication between the fracture site and the external environment.
what are the common open fractures
tibial, phalangeal, forearm, ankle, and metacarpal.
What can open fractures lead to
Tenting of skin and therefore breaks and wounds
Soft tissue damage
Neurovascular damage
Infection
What is the classification system used for open fractures
Gustilo-Anderson classification
- check on TMS
What investigations would you carry out for open fractures
X rays
Group and save
Routine bloods
How do you manage a open limb
Realignment and splinting
Repeat neurovascular exam
Tetanus vaccination
Photograph wound
Wash out debris using saline soaked gauze - not for theatre
What is the definitive management of open fractures
Surgical debridement
Ensure the wound is washed out with copious volumes of saline. Ensure definitive skeletal stabilisation; if soft tissue coverage is required, this should happen within 72 hours, or as guided by plastic surgeon advice.
