Management of Open Fracture

Gu-Hee Jung

doi:10.12671/jkfs.2010.23.2.236

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Jung: Management of Open Fracture

Review Article

Journal of the Korean Fracture Society

Journal of the Korean Fracture Society 2010; 23(2): 236-250.

Published online: 30 April 2010

DOI: https://doi.org/10.12671/jkfs.2010.23.2.236

Management of Open Fracture

Gu-Hee Jung, M.D.

Address reprint requests to: Gu-Hee Jung, M.D. Department of Orthopaedic Surgery, Kosin University Gospel Hospital, 34, Amnam-dong, Seo-gu, Busan 602-030, Korea. Tel: 82-51-990-6229, Fax: 82-51-243-0181, jyujin2001@kosin.ac.kr

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Figures and Tables

Figure 1

For staged operation, the preliminary stabilization was achieved with spanning external fixator. The entire skin of limb can be easily managed while the soft tissue is healing.

Figure 2

A muscular atrophy and pin site infections occurred to the lower leg due to chronic application of Ilizarov apparatus.

Figure 3

(A) A 46-year-old man sustained a type II open fracture of tibia.

(B) Open wound about 2 cm was located on the medial aspect of lower leg.

(C) The primary fixation with Ilizarov apparatus was applied.

Figure 4

The type IIIB open fracture of tibia was healed without infection and joint stiffness.

(A) The fracture was primarily stabilized with the intramedullary nailing and (B) A soft tissue injury was reconstructed by the latissimus dorsi muscle flap.

Figure 5

(A) A definitive external fixation was achieved with Ilizarov apparatus combined with plate and screw.

(B) However, the implant and bone were exposed due to soft tissue necrosis.

Figure 6

A 54-year-old man sustained a open type II fracture of distal humerus.

(A) Simple radiograph and clinical photograph show the distal shaft fracture and the anterior open wound.

(B) The radial nerve was injured at the fracture site.

(C) The fracture was primarily fixed with a locking plate with attention to further damage of the soft tissue.

(D) 2 weeks later, the nerve graft was done with additional plating.

(E) The postoperative radiographs show the anatomic reduction and (F) radiographs taken 14 weeks after surgery, satisfactory union and alignment.

Figure 7

(A, B) A 59 year-old man had a type IIIA open shaft fracture of the ulna.

(B, C) After the surgical debridement, the primary internal fixation using the locking plate was applied, but the skin was not closed.

(D) The fracture was healed without complication.

Figure 8

(A, B) A 78 year-old woman sustained the multiple fractures and type I open fracture of right femur.

(C) For staged operation of open fracture, the preliminary stabilization was achieved with a spanning external fixator.

(D) 2 weeks later, the fracture was managed with minimally invasive plate osteosynthesis.

(E) Radiographs taken 4 months after surgery show the process of bone union and no infection.

Figure 9

(A) A 33-year-old man sustained type IIIB open tibia shaft fracture with medial soft tissue injury.

(B) The preliminary stabilization was achieved a hybrid external fixator.

(C) The fracture was managed with minimally invasive plate osteosynthesis because of cruciate ligaments injury and the postoperative radiographs showed the functional reduction.

(D, E) The fracture was healed without complication.

Table 1

Gustilo classification of open fractures35)

Table 2

Proposed open pelvic fracture clasification7)

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