OPEN FRACTURE

ATLS
 Definition
Open fracture : a fracture with direct
communication to the external environment
 ATLS
• Fracture management begins after initial
trauma survey and resuscitation is complete:
airway, breathing, circulation, disability, and
exposure (ABCDE)
• Control bleeding
– direct pressure will control active bleeding
– do not blindly clamp or place tourniquets on
damaged extremities

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• Dressing
– remove gross debris from wound, do not remove
any bone fragments
– place sterile saline-soaked dressing on wound
– ???aggressive irrigation or irrigation with
antiseptic solution????
• Stabilize
– splint, brace, or traction for temporary
stabilization 
– decreases pain, minimizes soft tissue trauma, and
prevents disruption of clots
• Antibiotics
– initiate early IV antibiotics and update tetanus
prophylaxis as indicated
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