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Principles of Treatment of Open Fractures

All open fractures assumed to be contaminated Prevent infection! The essentials: Prompt wound debridement Antibiotic prophylaxis Stabilization of the fracture Early definitive wound cover Repeated examination of the limb because open fractures can also be associated with compartment syndrome

Antibiotics for open fractures

CONTRAINDICATIONS TO SURGICAL REDUCTION AND STABILIZATION


Situations in which there is a high probability for failure with operative treatment are as follows:
1. Osteoporotic bone that is too fragile to allow stabilization by internal or external fixation. 2. Soft tissues overlying the fracture or planned surgical approach of such poor quality because of scarring, burns,active infection, or dermatitis . 3. Active infection or osteomyelitis 4. Fracture comminution to a degree that does not allow successful reconstruction. This is most commonly seen in severe intraarticular fractures. 5. General medical conditions that are contraindications to anesthesia are generally contraindications to the surgical treatment of fractures. 6. Undisplaced or stable impacted fractures in acceptable position do not require surgical exposure or reduction. 7. Inadequate equipment, manpower, training, and experience.

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