The Journal of Bone and Joint Surgery (American). 2007;89:884-895.
© 2007 The Journal of Bone and Joint Surgery, Inc.
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Instructional Course Lecture

Management of Open Fractures and Subsequent Complications

Charalampos G. Zalavras, MD1, Randall E. Marcus, MD2, L. Scott Levin, MD3 and Michael J. Patzakis, MD1

1 Department of Orthopaedic Surgery, University of Southern California Keck School of Medicine, 2025 Zonal Avenue, GNH 3900, Los Angeles, CA 90089-9312
2 Department of Orthopaedic Surgery, Case Western Reserve University/University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106
3 Duke South Hospital, Room 134, Baker House, Brown Zone, Trent Drive, Durham, NC 27710

An Instructional Course Lecture, American Academy of Orthopaedic Surgeons

The first 150 words of the full text of this article appear below.


   Introduction
 
Open fractures are associated with an increased risk of infection and healing complications. Management of open fractures is based on the following principles: assessment of the patient, classification of the injury, antibiotic therapy, débridement and wound management, fracture stabilization, early bone-grafting, and supplemental procedures to achieve healing.


   Assessment, Classification, and Antibiotic Therapy
 
Open fractures are usually the result of high-energy trauma and should alert the treating physician to the possibility of associated injuries. Therefore, detailed evaluation and appropriate resuscitation of the patient are necessary. The neurovascular status of the injured extremity should be carefully assessed, and the development of compartment syndrome should not be overlooked1. The soft-tissue injury should be evaluated to determine the size and location of the wound, the degree of muscle damage, and the presence of contamination.

The Gustilo and Anderson classification system2, which was subsequently modified by Gustilo et al.3, is used widely to grade . . . [Full Text of this Article]


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