title: Case report: treatment of open femoral shaft fracture in a severely burned patient.
abstract: OBJECTIVE
  To present a case report of a patient with an open fracture and severe burns and review the literature.
  
  
  METHODS
  The patient was treated with intubation, intravenous antibiotics, and debridement and intramedullary nailing for the femur fracture. He later underwent multiple burn excision procedures with allograft and autograft skin coverage. The wound over the fracture was treated with dressing changes. The fracture was treated with nail exchange and bone grafting for atrophic nonunion.
  
  
  RESULTS
  The patient was returned to full weightbearing and good function with a fully healed femur.
  
  
  CONCLUSIONS
  Treatment of open fractures in burn patients should be tailored to the specific needs of the individual; they should be reduced and stabilized via internal fixation at the earliest opportunity and should be managed by minimizing wound colonization through successive debridement, wound care, and consideration of flap coverage.
authors.affiliation: Department of Orthopaedic Surgery, Johns Hopkins University/Johns Hopkins Bayview Medical Center, Baltimore, MD, USA.
authors.forename: Tai-Li
authors.initials: TL
authors.lastname: Chang
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Spence
authors.forename: Simon C
authors.initials: SC
authors.lastname: Mears