Abstract
Any fracture in which the fracture haematoma communicates with the outside world is an ‘open fracture’. All open fractures must be treated as a surgical emergency with a clear treatment protocol using a team approach. The accident and emergency (A&E) department forms the initial part of that team. The guiding principles for the team are to prevent infection, unite the fracture and restore function - it is in the first of these that A&E plays an important role. The A&E team will also need an understanding of subsequent management to ensure good initial treatment and communication with the orthopaedic surgeons, patient and relatives.
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