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Compound Fracture Surgery | Compound Bone Fractures Recovery

Here is what you should do if you fracture compound.

Overview

Compound fractures, also known as open fractures, are caused by direct and powerful traumas like the ones commonly received during sports and vehicle accidents. This type of fracture is characterized by broken skin with the fragmented bone usually tearing the epidermis. Compound fractures are considered as the more serious classification of fractures because it can lead to extreme blood loss and infection. Unlike closed fractures which can be treated with first-aid, this type requires immediate emergency treatment. Compound fractures definitely will need surgery to rejoin bones together.

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Compound Fracture Types

• Type I- the wound caused by the injury is small. The broken skin is usually no larger than 1 cm in diameter and looks clean with no complicated fracture pattern. This type of fracture does not cause any crushing of the skin.

• Type II- the wounds are larger with the laceration measuring larger in 1 cm diameter but sill without severe crushing of the soft tissues. No degloving, flaps, and contusion of the skin is present but the fracture pattern may appear to be complex as compared to Type I.

• Type III- the type of compound fracture with severe injury on the soft tissues. Can either be a single or a segmental fracture and classified into three types. A) Type IIIA—is the subtype wherein there is still coverage of the soft tissue on the fractured site despite of suffering from a powerful trauma or severe laceration. B) Type IIIB—there is inadequate coverage of the soft tissues with stripping of the periosteal. This type requires reconstruction of the soft tissues through surgery. C) Type IIIC—any type of compound fracture that caused severe vascular injury.

Diagnosis

A compound fracture does not need much diagnostic steps because most of its cases are immediately sent to the emergency room for surgery. All the same, the steps in diagnosing a compound fracture involve cleaning the wound and possibly blocking the wound to prevent extreme loss of blood (for fracture Type IIIC). Antibiotics are given to the patient via muscle injection to prevent the development of an infection. An intravenous (IV) line containing cefuroxime may be administered in order to prepare the patient’s body to general anesthesia. The individual will be provided with tetanus immunoglobin to prevent tetanus.

Compound Fracture Causes

• Direct blows- from vehicle, falling, and sports accidents
• Indirect blows-individual hitting a hard surface
• Slipping and using the injured part in breaking the fall

Symptoms

• Broken bone piercing through the skin
• Extreme bleeding
• Lacerations on the affected area

Compound Fracture Treatment

After the basic diagnosis of the compound fracture, the patient is immediately sent to the surgery room with the main agenda of realigning the fragmented ends of the injured bones. The fracture site is usually immobilized either by using external splints or tools that will be internally implanted inside the body. The use of external tools is very rare but this can be administered to those who have Type I compound fractures. Before the surgery, the patient is given blood/fluid replacement to make sure that he will not suffer from blood loss. The wound is then irrigated with saline fluid and will be covered with moist dressing for a couple of minutes before moving on with the actual surgery.

During the surgery, the ends of the fractured bones will be joined together with the use of metal plates, screws, and rods. Afterwards, the wound will be closed with stitches and will be covered with sterilized dressing. Once the stitches have healed a little, the fractured area will be placed on a sling or a cast for immobilization. The casts usually need to be worn for about 7-8 weeks. Physical therapy is generally required by the doctor but it depends on the type of injury. The therapy can also be done even the cast is still in place. Physical therapy exercises are needed to condition the injured part back into its working condition.

Prevention

Most compound fractures are caused by powerful direct blows so the best prevention is to take it easy in driving and being careful when doing hazardous sports/activities. Wearing protective gear can help a lot like knee and arm pads.

When to Call a Doctor

A patient with a compound fracture should immediately go to the emergency room of the hospital but better if somebody calls the emergency hotline so that the paramedics will be the one to take the patient. This is to avoid unnecessary movement of the compound fracture because if there are fragmented bones inside the injured area, moving the injured part can bring more damage to the already damaged bones, ligaments and tendons.
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