https://www.uptodate.com/contents/general-principles-of-fracture-management-bone-healing-and-fracture-description?source=see_link§ionName=Orientation:%20Transverse,%20oblique,%20and%20spiral&anchor=H6#H6, https://www.uptodate.com/contents/severe-extremity-injury-in-the-adult-patient, http://orthoinfo.aaos.org/topic.cfm?topic=A00582, http://emedicine.medscape.com/article/1270717-overview#showall, https://www.uptodate.com/contents/overview-of-stress-fractures?source=search_result&search=stress%20feacture&selectedTitle=1~150#H28, http://emedicine.medscape.com/article/1252306-overview#a7.
Injudicious efforts at salvage may be doomed to failure, with the risk of life-threatening complications, particularly infection.The decision whether to amputate, or to try to save, a severely injured limb is one of the most controversial in trauma surgery. “The most frequent causes of infection in patients with open fractures are: Forty-eight hours after the original débridement, it is generally advisable to reinspect the injury zone under anesthesia – so-called “second look”. J.Trauma Aug;24(8):742-6); and also that of the AO.An additional influence is the ability of the host to combat infection, based on both systemic and local factors.
Bony stability in open fractures helps associated soft-tissue wounds to recover, by providing the best possible setting for soft-tissue healing and resistance to infection. 6. Temporary open wound management with delayed primary closure, or preferably split skin grafting, is the safest approach for the majority of open fractures. People with open fractures usually have some treatment from ambulance staff at the scene of the accident. demonstrated a 50% risk of osteomyelitis after such injuries, with amputation (early or late) a frequent outcome ( Gustilo et al. Temporary open wound management with delayed primary closure, or preferably split skin grafting, is the safest approach for the majority of open fractures. If this isn't possible, they may be given as a spray up the nose.
17 February 2016 High and Low Pressure Pulsatile Lavage of Contaminated Tibial Fractures: An In Vitro Study of Bacterial Adherence and Bone Damage. deWeber K. Overview of stress fractures. Otherwise damaged tissue should usually be removed within 12 hours and should be removed within 24 hours of injury. This is done only after thorough injury zone débridement. A sealed dressing (e.g., antibiotic bead pouch, or vacuum-assisted wound closure (VAC)) can be used.
When people with open fractures are taken to hospital in an ambulance, the type of hospital they are taken to will depend on where the fracture is and the care that they need.
The III grade was later further subdivided into types IIIA, IIIB & IIIC.