Open Fractures: Mechanisms, Clinical Features and Complications
Inability to weight bear
Limb length discrepancy
•
Loss of sensation distally
Deformity
Gustilo-Anderson Classification
Type I
Wound < 1cm Typically "inside out" injury Yir Minimal comminution Type II Wound 1-10 cm 4, Possible tissue contamination Moderate comminution Note: • Open fractures can occur with low risk mechanism, typically with diseased bone Legend: *Motor cycle/car crashes, pedestrian vs. car, gun shot Direct, high energy force* Open Fractures Fractures with varying degrees of comminution Type Ill Yir Wound >10 cm
4,
Extensive
contamination
Extensive
comminution
Type IIIA
Adequate soft tissue
for bone coverage
Legend: Pathophysiology Mechanism
Complications
Open wound
Contusion/Blisters
Compartment syndrome
Bone tenting or
protruding through a
wound
Loss of distal pulses
Amputation
Type IIIC
Vascular injuries,
possible amputation
•
Type IIIB
++ soft tissue damage
with periosteal stripping
Sign/Symptom/Lab Finding
Non-
union
Deep Vein
Thrombosis
Delayed
union
Infection
Authors:
Meaghan MacKenzie
Reviewers:
Annalise Abbott
Usama Malik
Dr. Prism Schneider*
* MD at time of publication