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- Title
Management of open fractures: part 2.
- Authors
Perry, Karen L.
- Abstract
Open fractures have been considered one of the true orthopaedic emergencies by some, however, optimal treatment has not been definitively described. Significant debate has focused on the most appropriate method by which to manage open fractures, but general principles of treatment are well established. Principles include fracture classification, antibiosis, irrigation, debridement, wound management and fracture stabilisation. In this second in a two-part series on open fracture management, debridement, wound management and fracture stabilisation will be explored; the initial management of the patient was discussed in the first article in the series. Debridement should be performed on an urgent but not emergent basis; adequacy of debridement and timeliness of soft tissue coverage are probably more important than time from injury to debridement. Once the wound has been appropriately irrigated and thoroughly debrided, early aggressive treatment, with rigid bone fixation and soft tissue reconstruction, is widely accepted as the treatment of choice. Generally, type 1 and 2 open fractures can be stabilised using the same method of fixation as would be used for a closed fracture of similar configuration, while the extensive soft tissue damage associated with type 3 fractures may preclude internal fixation.
- Subjects
COMPOUND fractures; WOUND care; ORTHOPEDICS; ANTIBIOSIS; FRACTURE fixation; DEBRIDEMENT
- Publication
UK-Vet Companion Animal, 2016, Vol 21, Issue 4, p196
- ISSN
2053-0889
- Publication type
Article
- DOI
10.12968/coan.2016.21.4.196