Open fractures and types
Open fractures are those that have breach of the skin continuity and there is also a possibility of communication of fractured elements with outer environment. Open fractures are the most dangerous of all fractures, because they are almost always followed by some complications such as infections, inability of fracture to heal properly, inability of using fractured extremities after recovery, and increased mortality because of bleeding, since big blood vessels can be damaged in this type of fracture. To determine the best method of therapy and for predicting the outcome of the condition, there are three types of open fractures.
- First type – fracture happened due to the force of small intensity, skin laceration is not longer than 1 inch, wound is relatively clean and bone fragment is barely visible from outside. Soft tissues are not damaged much, if at all.
- Second type – medium force causes this type of open fracture. Minor dislocation of the broken fragments is present and those fragments can be seen. Soft tissue is damaged to a certain point and contusion also happens.
- Third type – fracture is caused by maximum force. This is dislocated type of fracture and bone fragments might be completely detached. Skin loss is present and extensive, muscles are severely damaged, tendons and other tissues are also affected. The most difficult recovery happens in this type of fracture. Antibiotics are needed, while the wound has to be tendered by a surgeon.
Possible complications of open fractures
Complications usually happen more in open than in closed fractures. The most common problem that might emerge is infection, which happens because part of the skin is gone and wound is open to the outer environment and all sorts of bacteria might affect it. This is especially emphasized if a wound was in a contact with dirt or some other material, which usually happens. It is extremely important that the surgery is done as fast as possible, in order to close the wound and prevent further spread of infections.
Improper healing and recovery is manifested as slow healing, incomplete accretion (called pseudoarthrosis), or the accretion that was simply wrong, leaving a deformity. Incomplete accretion can happen because of several reasons, as a consequence of osteoporosis and infection. This leaves a patient with extremity with disabled function, which makes walking, for example, very difficult (if leg was fractured). Wrong accretion results in a deformity that ends in a complete or partial dysfunction of the recovered bone. Open fracture complications, if left untreated or if treated poorly, can severely damage patient’s use of the broken extremity, or even the life of the patient, so those fractures have to be immediately and properly treated.