Abstract
Open fractures (Fig. 2.1) are common orthopedic injuries with potentially serious sequelae. Approximately 8–10% of all open fractures result in amputation, and various studies have shown that infection rates following open fractures are as high as 24%. Even if you are not at the center that is going to be definitively treating a patient with an open fracture, you can assist in their care and improve the outcome. The most important factor in terms of decreasing infections related to open fracture is the time taken to administer antibiotics. Studies suggest that greater than 65 min from injury to antibiotics is an independent risk factor for developing an infection.
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An important caveat: If you encounter a patient who had a bone spike delivered through the skin that is grossly contaminated (mud, feces, etc.), contact the orthopedic surgeon on call prior to attempting a reduction, as any reduction may seed clean tissue with contaminant.
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Johnson, J.P. (2017). Open Fractures. In: Hodax, J., Eltorai, A., Daniels, A. (eds) The Orthopedic Consult Survival Guide. Springer, Cham. https://doi.org/10.1007/978-3-319-52347-7_2
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DOI: https://doi.org/10.1007/978-3-319-52347-7_2
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