Open fractures are broken bones that pierce the skin, exposing the bone and other tissues so they’re visible. These fractures happen as a result of trauma, like auto accidents, falls, or sports injuries.
Not surprisingly, open fractures require special treatment to repair the bone and prevent complications. In this post, Thomas E. Powell, MD, and the team at Powell Orthopedics and Sports Medicine review the basics of open fractures, including their treatment.
Open fractures involve breaks in your skin, and that means the bone and underlying tissue are exposed to germs and other contaminants in the environment. Not surprisingly, that means the risk of infection is significantly higher for open fractures compared to closed fractures where the skin remains intact.
The first step in treating an open fracture is to clean the wound to remove dirt and other contaminants, a process called debridement and irrigation.
Debridement involves removing dirt and any other foreign material from the wound, as well as excising damaged tissue. Depending on the size of the open wound, your doctor may need to make a larger incision to access and remove all the affected tissue.
During irrigation, your doctor uses a special fluid to gently wash the wound. Irrigation dislodges tiny particles of debris to further reduce the risk of infection.
Once these initial steps are complete, your doctor maps out the next phase of treatment: stabilizing the bones so they heal properly.
Open fractures don’t just damage the bone. They can cause damage to surrounding structures, too, like soft tissues, connective tissues, blood vessels, and nerves. Surgery addresses all these issues for optimal recovery.
Open fracture surgery typically uses fixation to hold the ends of the bones together. Depending on your needs, we may use internal fixation or external fixation.
In the internal fixation technique, the doctor uses special surgical hardware, like screws, rods, or plates, to hold the ends of the broken bones together. The hardware may be placed on the outside or the inside of the bones.
Surgical hardware is made of biocompatible materials that won’t cause sensitivity issues or allergies. Hardware may be removed after the bones “knit” together, but it can also be left in place.
External fixation begins with screws or pins that are placed through your skin and into a healthy area of the broken bone. Then, the doctor attaches a metal rod or bar to the pins or screws. This rod or bar holds the bone steady while it heals.
External fixation allows your doctor to care for a severe wound that may need further debridement later — for instance, if there’s a danger of additional tissue death. It may be used alone or, for more serious fractures, we may use external fixation for the initial stages of healing, followed by internal fixation.
With either technique, you need to take antibiotics to help prevent infection, and you may need a skin graft to replace damaged tissue or cover a very large wound.
All fractures require immediate medical treatment to prevent more serious complications. To learn how our team can help you heal and recover following an open or closed fracture injury, call 205-606-5232 or request an appointment online with Powell Orthopedics and Sports Medicine in Vestavia Hills, Alabama, today.
