[Treatment of open fractures exemplified by tibial shaft fracture].
Main goals in open fracture treatment is to avoid deep infections and achieve uneventful bone healing. Because post-traumatic soft tissue trauma and risk for contamination is underestimated in most cases, the therapeutical protocol must be followed consequently to avoid problems. Strategy includes decontamination by radical debridement, wound lavage, revision surgery, early antibiotics, fasciotomy to secure soft tissue perfusion, no primary skin suture and fracture management by biologic fixation methods. In special cases, temporary shortening and callotaxis after soft tissue healing is indicated. After solid soft tissue healing, fracture treatment is unproblematic in most cases. Following this concept, complication rates in open tibial shaft fractures are extremely low.
Muhr
G
G
Chirurgische Klinik und Poliklinik der Berufsgenossenschaftlichen Kliniken Bergmannsheil, Universitätsklinik, Bochum.
Ostermann
P
P
D016267:External Fixators; D005594:Fracture Fixation, Intramedullary; D005597:Fractures, Open / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007870:Leg Length Inequality / Q000000981:diagnostic imaging / Q000601:surgery; D019857:Osteogenesis, Distraction; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery; D011859:Radiography; D012086:Reoperation; D017695:Soft Tissue Injuries / Q000000981:diagnostic imaging / Q000601:surgery; D013536:Suture Techniques; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D014946:Wound Infection / Q000000981:diagnostic imaging / Q000517:prevention & control