Coupon Accepted Successfully!


Management Plan of Compound Fractures

  1. Immediately debride the wound of contaminated and devitalized tissue, copiously irrigate, and repeat debridement with in 24-72 hours.
  2. Stabilize the fracture with the method determined at initial evaluation.
  3. Type & Method of fixation
    Type I Technique that is suitable for closed fracture management i.e. internal fixation by intramedullary nail & plate.
    Type II, III A. Controversial; external fixation sometimes non reamed intramedullary nail
    Type III B, III C. External fixation is the primary method for salvageable injuries
Description: Description: http://upload.wikimedia.org/wikipedia/commons/thumb/3/3c/External_fixator_xray.jpg/300px-External_fixator_xray.jpg
(Open Fracture manage with External Fixator)
(Open Fracture manage with Vacum Asistent Closer -VAC)
  1. Aggressive debridement and irrigation
    1. Thorough debridement is critical to prevention of deep infection
    2. Low pressure lavage more effective in reducing bacterial counts than high pressure lavage
    3. saline shown to be most effective irrigating agent (On average, 3L of saline are used for each successive Gustilo Type I: 3LType II: 6LType III: 9L)
    4. Bony fragments without soft tissue attachment can be removed
  2. Fracture stabilization
    • Can be with internal or external fixation, as indicated
  3. Staged debridement and irrigation
    • Perform every 24 to 48 hours as needed
  4. Early soft tissue coverage or wound closure is ideal
  5. Can place antibiotic bead-pouch in open dirty wounds
    • Beads made by mixing methylmethacrylate with heat-stable antibiotic powder

Test Your Skills Now!
Take a Quiz now
Reviewer Name