Management of Open Fractures of the Extremities and Pediatrics
Philip K Lim1, Jacques Hacquebord, Babar Shafiq
1From the Department of Orthopaedic Surgery, UC Irvine, Irvine, CA (Lim and Gupta), the Department of Orthopaedic Surgery, NYU, New York, NY (Hacquebord), the Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD (Shafiq), and Hansjorg Wyss Department of Plastic Surgery, New York University, New York, NY (Hacquebord).
Insights
Optimal treatment for open fractures focuses on reducing infection risk. This review examines current literature on antibiotic timing, surgical procedures, and management strategies for various open fracture types.
Area of Science:
- Orthopedic Surgery
- Infectious Disease Management
Background:
- The Gustilo and Anderson classification established modern open fracture management.
- Reducing infection risk remains a primary goal in treating open fractures.
Purpose of the Study:
- To review the latest literature on open fracture management.
- To provide current treatment recommendations for open fractures.
Main Methods:
- Literature review of recent studies on open fracture treatment.
- Analysis of data supporting current management guidelines.
Main Results:
- Optimal timing for antibiotics and surgical procedures is continuously refined.
- Management strategies vary for upper extremity, lower extremity, and pediatric open fractures.
Conclusions:
- Evidence-based guidelines are essential for optimizing open fracture care.
- Ongoing research aims to further minimize infection risks and improve outcomes.
Abstract:
The modern management of open fractures was established after the foundational work of Gustilo and Anderson, but we continue to strive to determine the optimal treatment of open fractures to diminish the risk of infection. The ideal timing of antibiotics, presentation to the operating room, and timing of procedures such as flap coverage continue to be investigated with incremental changes recommended over the years. This article aims to provide the most recent review of the literature regarding the timing and management of both upper and lower extremity open fractures, pediatric open fractures, current topics of controversy, and the data supporting current treatment recommendations.
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