Compound FracturesManagement
General & Local
Early
• Medico legal record• Pt’s identification marks, Pt. bought by,
Detailed history & injury notes , Police information
• Investigations –Hemogram, BSL, BUN, S. Creatinin, Blood grouping, X-ray, USG, CT scan
• Catheterization• Renal perfusion - Hypotension, crush syndrome
Local
• As soon as patient is hemo dynamically stable at the EARLIEST
• Cleaning
• Debridement
• Stabilization
• Under Anesthesia
Cleaning
• Repeated
• Using about 3 to 4 liters of normal saline till all the foreign material is removed.
• May add mild detergent to Normal Saline
• Addition of antiseptics, H2O2, Not recommended as it may injure soft tissues & discoloration will confuse the vitality signs
Debridement
• Excision of all dead tissue
• Excision of all contaminated tissues with foreign material which can not be removed by cleaning
• Including every piece of bone without soft tissue attachment in spite of its size
• Soft tissue till bleeding edge
• Muscles till bleeding contractile pink muscle
• Send Culture Swab For C & S
• NO Sutures
stabilization
• Debridement repeated after 24 hours and there after till no dead tissue remains
• Splints• Simple• Traction Splints- Fixed traction, Dynamic traction
• Plasters • Slabs,
• Casts, Window dressing
External Fixators
• Uni- plainer• Simple
• Complex Joint spanning
• Multi-plainer• JESS• Ring
External Fixator
External FixatorComplex
Ring Fixator
Top Related