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#1
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04-24-2012, 04:27 PM
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 ♚ Legacy Gold Member ♚ Poster Rank:34 Female Join Date: Nov 2008 Posts: 43,403
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Nasty Open Fractures
The potential prognosis for even a well-managed open fracture may be loss of limb. Because proper management greatly reduces the risk of a poor prognosis, and because there is a critical time window in open fracture management protocol, all open fractures should be treated as an emergency. The prognosis depends on the potential for infection, nonunion or malunion, direct loss of function due to tissue damage, and soft tissue coverage for wound healing. Soft tissue coverage is critical in achieving a good outcome. In the foot and lower leg there is little soft tissue covering the bone, which means there is greater likelihood for skin penetration with lower energy injuries. It also means that in higher energy injuries there is less chance of having adequate coverage, making it a more vulnerable wound. The amount of soft tissue damage is directly related to the amount of energy at the time of energy. Significant impairment may result without adequate coverage sometimes necessitating primary amputation. CLASSIFICATIONS I. Clean wound, < 1 cm long. 0% infection rate. II. Laceration > 1 cm w/o extensive soft tissue damage, flaps, or avulsion. 3% infection rate. III A. Adequate soft tissue coverage despite extensive laceration (generally longer than 10 cm). 7% infection rate. III B. Extensive soft tissue loss w/ periosteal stripping and exposed bone. 10%-50% infection rate. III C. Arterial injury requiring repair. 25-50% infection rate (amputation rate >50%).  ·  ·  ·  ·  ·  ·  ·  ·  ·  ·  ·  ·  ·  ·  ·  ·  ·  · |
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#5
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04-24-2012, 08:18 PM
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| ♚ Legacy Gold Member ♚ Poster Rank:34 Female Join Date: Nov 2008 Posts: 43,403
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Re: Nasty Open Fractures
I just looked at these again and have added another frown line to my face  I really HATE wounds like these, gives me the shudders!
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#7
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04-24-2012, 09:18 PM
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 ♚ Legacy Gold Member ♚ Poster Rank:35 Join Date: Mar 2012 Posts: 43,070
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Re: Nasty Open Fractures
Holy crap!! 4th from the bottom is just creeping me out. My cousin did this to his arm, falling off a bunkbed and snapped it half. He said that he didn't even feel pain until hours later, after surgery. I don't care if it hurts or not though, I don't want any of that.
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