OPEN FRACTURE MANAGEMENT: UPDATE ON INITIAL EVALUATION AND CLASSIFICATION

Abstract

This article reviews the management of open fractures, which occur when there is a break in the skin exposing the underlying bone and soft tissues, leading to signicant morbidity and mortality. The article focuses on the initial evaluation, classication, and treatment of these fractures. The Gustilo-Anderson classication system, which is based on the degree of soft tissue injury, is the most widely used classication system for open fractures. However, the Tscherne classication system, which focuses on the severity of soft tissue injury and the degree of fracture displacement, has been shown to be a more reliable predictor of infection and nonunion in some studies. The article also covers the AO/OTA classication system, a newer classication system that integrates important aspects of the Gustilo-Anderson classication system to provide more comprehensive guidance for the treatment of open fractures. Treatment of open fractures is complex and requires a multidisciplinary approach guided by the severity of the injury. Early antibiotics, early surgical debridement, and wound irrigation have been shown to reduce the risk of infection and improve outcomes. Patients with open fractures were more likely to have associated injuries, longer hospital stays, and higher hospital costs compared to patients with closed fractures