Open Injuries, also known as complex fractures are fractures with open wounds or damaged skin near the location of a fracture. Most often, these injuries are caused by bone fragments that penetrate the skin at the time of the injury.
Open injuries require different treatments from a closed fractures injury, where no injuries are found. Because after the skin is damaged, bacteria from dirt and other contaminants can enter the wound and cause infection. For this reason, early treatment of open injury fractures focuses on preventing infection at the site of injury. Wounds, tissues, and bones must be cleaned as soon as possible with surgery. Broken bones also need to be stabilized so that the wound heals.
The severity of an open injury fracture depends on several factors, including:
- The size and number of the fractured bone fragments
- The damage to surrounding soft tissues
- The area of the wound the area should have a good blood supply
Bone Loss Trauma
Open injuries with broken bones that penetrate the skin cause bone loss trauma. It is important because if a broken bone penetrates the skin, immediate treatment is needed, and surgery is often required to clean the fracture area. Because of the risk of infection, healing problems are more common if the fracture occurs with bone loss and open injury to the skin.
Bone loss trauma usually caused by high energy injuries such as car accidents, falls, or sports injuries.
Open injuries And Bone Loss Trauma Infection:
All open injuries with bone loss trauma considered contaminated due to communication between the fracture site and the environment outside the body. Although the level of actual contamination can vary. The possibility of bacteria entering the fracture depends on several variables, including the severity of the injury, soft tissue damage, and the environment in which the injury occurred.
The bacteria that are most likely to infect wounds are normal bacteria on the surface of your body’s skin. For this reason, the majority of fractures found infected with staph or streptococcal infections. Open fractures in the foot can contain other bacteria. Besides, damage detected in specific environments can cause exposure to certain bacteria. For example, farmers who have open injury fractures get contaminated with soils that have various types of infections that may require special antibiotic treatment.
Open Joint Injuries Treatment
Open injury with bone loss trauma requires emergency surgery to clean the area of injury. Because the skin is damaged, deposits and infections can replace fractures and cause high infection rates in the bones. After an infection is identified, it will be difficult to resolve the problem.
In addition to cleaning wounds, treatment must also include appropriate antibiotics and fracture stabilization. Patients should get tetanus if they are not current or do not know their vaccination status.
Treatment of established bone trauma often requires several operations, long-term antibiotic therapy. Therefore, every effort must be made to avoid this potential problem with early treatment. Despite this first treatment, patients with open injuries are still very vulnerable to bone infections.
Types of surgeries For Bone Loss Trauma:
- Ilizarov surgery: The Ilizarov surgery uses in orthopaedic surgery uses the external fixation device to extend or reshape bones. As a technique, the treatment of complex and open fractures, and in case of irregularities of infected bones that are not subject to other methods.
- Limb reconstruction system: Limb reconstruction refers to a technique in which the shape and function or length of the bones in the arm or leg have changed due to birth problems or injuries. Limbs Reconstruction surgery lengthens or straightening or “reconstructing” bones or joints using an external holder or frame.
- Masquelet technique: The Masquelet technique, which uses a temporary cement separator followed by a gradual bone graft, is a newer treatment strategy for treating post-traumatic bone defects.
General Procedure For Open Bone Trauma:
With this procedure, a doctor places metal implants – such as plates, rods, or screws – on the surface or broken bones. The implant maintains the position of the bones and joins them until the fracture heals. Sometimes bone grafting needed if minute bone material missed with the injury.
Internal fixation used to treat open injury fractures where:
- The wound is clean,
- There is minimal skin or tissue damage, and
- Broken bones can be aligned properly
It can be done as the first surgery or postponed when the soft tissue needs to heal. After internal fixation, the injured area is repaired and immobilized in a sling or splint until the fracture heals. You will be given antibiotics for a certain period to prevent infection. During the healing process, your doctor will examine the wound to make sure there are no signs of infection.
In this severe open injury, the doctor closes the wound with stitches after the debridement and internal fixation. If your bone loss is not ready for permanent implants, A doctor can repair the injured open area from the outside. The severe open injuries with bone loss are initially stabilized by external fixation.
During this procedure, the doctor inserts a metal screw or pin in the location of the fractured bone. Pins and screws protrude beyond the skin, where they are attached to metal or carbon fibres.
External fixation has the advantage of stabilizing broken bones when your doctor treats wounds. In some cases, the injury may require additional grafting or transplantation to cover the injured bone.
In most cases, the external fixation retained until the internal fixation can be carried safely. However, an external fixation sometimes used to stabilize the bone until it has fully healed. It is removed during the second procedure when the fracture has healed.
Open fracture or severe injury requires immediate medical attention. The prognosis for open fractures depends on the severity of soft tissue injury. Overall, the risk of complications, including delayed infection and healing, is higher when soft tissue injuries are more severe.
Dr Vasu Juvvadi, the best trauma surgeon, provide loving care through specialized orthopaedic trauma training. Contact us now or call us today if you need the best surgery to avoid infections and for more information.