Panoramic Review of Open Fractures, Description, Epidemiology, Assessment, Classification, Treatment and Complications

Abstract

Introduction: An open or exposed fracture is a fracture that has communication with the external environment through a skin wound. Usually these types of severe fractures require treatment by the orthopedic and plastic surgery team to address both bone and soft tissue injuries. Objective: to detail current information related to open fractures, description, epidemiology, evaluation, classification, treatment and complications. Methodology: a total of 33 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 20 bibliographies were used because the other articles were not relevant to this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: exposed fractures, open fractures, acute trauma, compartment syndrome, vascular injury, debridement. Results: the general average age of onset is 45.5 years, the incidence decreases in men and increases in women with age. Automobile accidents are the most common cause of open fractures of the lower limbs, accounting for approximately 34.1% of these injuries. The highest incidence of open fractures in males is between 15 and 19 years, the highest incidence in females is between 80 and 89 years. Conclusions: Knowledge of the management of open fractures is of vital importance, due to the fact that this type of fracture presents a high risk of infections, as well as other types of complications. The initial approach to the injured individual with an open fracture should be based on the principles of Advanced Trauma Life Support (ATLS). Clinical and imaging evaluation is important in this type of fracture, as well as recognizing the value of the classification systems that play a critical role when treating surgically. Irrigation and debridement remain the gold standards for proper wound management. The most important point in the treatment of an open fracture is proper lavage and debridement. KEY WORDS: trauma, open fractures, bone exposure, treatment.