A compound fracture is another way of referring to an open fracture. This where a bone breaks and there is an open wound in the skin at or near the site. Usually, a piece of the broken bone punctures the skin at the time of injury. Tendons, nerves, and blood vessels are usually injured at the same time.
Compound fractures are usually caused by high impact events like vehicular accidents or gunshots. However, sports injuries or a major fall can also cause them. In some cases, a large bone protrudes through the skin, but the wound can also just be a small puncture.
These types of fractures are serious since bacteria, dirt and debris can enter the wound and cause infection. They are therefore treated differently than closed fractures where there is no break in the skin. The open area is cleaned during a surgical procedure and the bone is stabilized to allow the wound to heal. The severity of an open fracture depends on the size and number of broken pieces, the damage to soft tissue and the location of the wound.
Diagnosis of Compound Fracture
An open fracture will in most instances send the patient to the emergency room. There, the doctor will conduct a physical examination and ask questions about how and where the injury occurred. The injured person will also be asked to share details about his or her medical history. The wound will be thoroughly examined to determine the extent of the damage. The doctor will also order x-rays in order to get a better look at the bone. CT scans or other types of imaging tests may be required to get more information.
Treatment of Compound Fracture
Compound fractures need to be treated urgently because of the risk of infection. This risk is higher if there is significant damage to the bone and soft tissues. Bone infections are difficult to treat and can require long-term use of antibiotics and multiple operations. Sometimes the infection is so bad that it can’t be cured, and the injured limb has to be amputated.
Doctors, therefore, focus on first preventing infection with antibiotics and a tetanus booster if necessary. After the wound is cleaned out and dressed, the doctor places the injured limb in a splint to keep the bones from moving until it is time for surgery. Open fractures are stabilized with either internal or external fixation.
Internal fixation means the doctor places metal plates, rods or screws on the surface of the bone or inside the bone. They keep the bone in its correct position and hold it together while the break heals. Internal fixation is used when the wound is clean, skin and tissue damage is minimal, and the fragments of bone can be properly aligned. The limb is then immobilized in a cast or splint.
External fixation is used if the wound and bones are not yet ready for a permanent metal implant. In severe open fractures, the doctor inserts the fixtures into the bone above and below the fracture site and they project out of the skin. This stabilizes the bone while making it possible to care for the wound. Once it’s safe to carry out the internal fixation, this procedure is usually done. Sometimes the external fixation stays until healing is complete.
Recovery from a Compound Fracture
The time it takes to return to regular activities after a compound fracture varies. Fractures in the lower leg take longer to heal than those in the thigh or upper arm. Conditions like diabetes may also delay healing. Generally, stiffness and discomfort can go on for several months and they can have an impact on daily activities. Physical therapy is necessary to help restore muscle strength, movement, and flexibility. In addition to attending sessions, you may also have to go through an exercise routine at home.