Physics of Open Fractures: Reconsidering Tissue Viability, Contamination Risk and Importance of Wound Debridement

Ahmed Abdelmoez Alsayed

doi:10.4236/jamp.2021.91012

Abstract

Understanding basic physics behind open fractures leads to a better understanding of mechanism of injury, open fractures pathophysiology and management. Explaining local changes in viability of open fracture involved tissues, importance of debridement and reconsidering contamination risks will be ultimate objectives after going through this review. The controversy is still there between minimal/conservative debridement of open fracture wounds in favour of direct closure of soft tissue on the same session against generous debridement and delayed closure by more complicated choices on the reconstructive ladder to avoid infection, delayed healing, wound chronicity, limb loss and prolonged hospital stay. In the article, basic physics behind open fractures is highlighted to gain a deeper understanding of tissue viability changes and contamination risks after injury.

Highlights

An open fracture is an injury where the fractured bone and/or fracture hematoma are exposed to the external environment through a traumatic defect of the soft tissue and skin
Basic physics behind open fractures is highlighted to gain a deeper understanding of tissue viability changes and contamination risks after injury
Speaking, if the collision exclusively affected the pedestrian lower leg, and as mentioned, it will lose some of its kinetic energy, that will be transferred to the pedestrian lower leg mostly in the form of potential energy (Inelastic collision), the collision will cause a stress against the integrity of lower leg tissues e.g. bone, muscle, skin, etc

Summary

Introduction

An open fracture is an injury where the fractured bone and/or fracture hematoma are exposed to the external environment through a traumatic defect of the soft tissue and skin. The skin wound may not lie directly over the fracture. Any fracture that has an associated wound should be considered open until proven otherwise [1]. Open fractures occur at a rate of 30.7 per 100,000 persons per year, most commonly due to motor vehicle accidents. The most common long bones fractured are tibia and fibula [1]

Numerical Examples of High Energy Trauma

Why Should We Debride All Open Fractures?

Conclusions