Mechanism of Injury, Clinical Features, Investigations, and Management of Open Fractures

Introduction

Open fractures are complex injuries involving bone exposure due to a break in the overlying skin and soft tissue. These injuries require meticulous care to prevent complications such as infections and delayed healing.

Mechanism of Injury

Open fractures commonly result from high-energy trauma, including vehicular accidents, falls from heights, and sports injuries. The severity depends on the force applied, type of impact, and associated soft tissue damage.

Clinical Features

• Visible bone exposure
• Severe pain and swelling
• Bleeding and potential neurovascular compromise
• Loss of function in affected limb

Investigations

Diagnosis involves a thorough clinical examination and imaging techniques such as:

• Radiography: Essential for assessing fracture location and severity
• CT scan: Provides detailed visualization of complex fractures
• MRI: Useful for evaluating soft tissue involvement
• Microbiological testing: Critical for identifying infection-causing pathogens

Management and Prevention of Secondary Infections

Immediate Care

• Debridement to remove contaminants
• Broad-spectrum antibiotic administration
• Stabilization using external or internal fixation

Long-Term Rehabilitation and Complications

Recovery from open fractures involves rehabilitation strategies such as:

• Physical therapy to restore mobility
• Bone grafting in cases of non-union
• Monitoring for complications like osteomyelitis and post-traumatic arthritis