Open Fractures

Open fractures (previously referred to as compound fractures) occur when a broken bone communicates beyond the surrounding skin.

Open fractures are associated with complex fracture patterns, joint dislocations, nerve injury, tendon injury and blood vessel injury.

Open fractures, due to their very nature, are at a risk of acute and chronic bone infection due to contamination of the bone due to the loss of skin cover.

Open fractures are also at a risk of taking longer for the bone to heal than simple closed fractures (delayed union) and in some cases the broken bone will not heal (non union).

The team at OTL work in the Imperial Limb reconstruction unit at the North West London Major Trauma Centre, which receives and manages all open fractures in North West London.

The principles of the management of open fractures include

  • Early administration of intravenous antibiotics
  • Thorough surgical debridement of the associated soft tissue +/- bone
  • Stabilisation of the broken bone (which may be temporary with an external fixator before definitive bone fixation)
  • Soft tissue coverage

OTL employ a multidisciplinary approach to the management of open fractures with combined Orthopaedic and Plastic surgery input on order to try and ensure the best possible outcomes and return to function.