Severe open tibial fracture prior to fixation!!
An open fracture, also called a compound fracture, is one in which there is an open wound or break in the skin near the site of the broken bone. Most often, this wound is caused by a fragment of bone breaking through the skin at the moment of the injury. Because the tibia is a subcutaneous bone, tibial fractures are frequently open fractures, which require emergent care. Motor vehicle accidents, skiing accidents, and high-energy and velocity traumas are the common causes. When an individual presents with an open tibial fracture, the physician strives to save the life of the patient and the limb, to unite the fracture, and to prevent infection. Maintaining a functional limb is the goal; when that is not possible, amputation should be considered. The management can be complex due to the relative lack of soft tissue coverage and blood supply of the tibial shaft. Intramedullary nailing is the best option to ensure union of the less severe fracture. External fixation is used in more extensive cases. Open fractures also result in high rates of infective complications, due to communication with the external environment. As such, antibiotic prophylaxis is usually administered before, during and after intraoperative surgical fixation.
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