[Principles for treatment of open fractures]

Fractures with soft-tissue injury are urgent surgical emergencies. Fracture care in the first few hours after the injury crucially determines the course of healing. In open fractures aggressive debridement of all necrotic tissues is mandatory as well as stable external or internal fracture fixation. Secondary wound closure must be performed liberally and prophylactic antibiotics should be administered. Closely observing such a stringent regimen, the rate of posttraumatic osteitis in open fractures can be reduced significantly.