Compound Fractures in the Adult

Abstract

Definitive internal fixation of compound fractures in the adult is undertaken either within the first six to eight hours or is deferred for one to three weeks while soft tissue healing takes place. If definitive internal fixation is deferred, temporary fixation of the fracture should be undertaken. If primary internal fixation is decided upon during the first six to eight hours, the surgeon should remember that two-thirds of all compound fractures fail to provide a positive swab culture from the depth of the wound. About one-third of wounds are contaminated. Infections occur when necrotic tissue is left in the wound, as this provides a nidus for bacterial multiplication. Thus, in all compound fractures, secondary hospital infections with resistent bacteria are more of a real problem than primary infection of the wound at the time of the injury.