Open fractures of forearm bones can occur in crush injuries of the limb, missile injuries and gun shot injuries. The diagnosis of an open fracture of the forearm is usually self-evident. There is history of bleeding or wound from the site of injury. In some cases there might be a spike of bone jutting out of the wound.

The limb must be examined to know the extent and severity of the injury. Small puncture wounds may have to be actively searched for if the active bleeding has stopped.  Presence of  wound increases the risk of infection and likelihood of insertion of foreign material.  A careful neural and vascular examination must be done as open injuries are most likely to cause neurovascular damage than closed fractures.

Emergent treatment is required for open fractures. A sterile dressing should be placed over the wound. Debridement should be done at earliest possible opportunity and the soft tissue damage should be evaluated before undertaking debridement to know the extent of damage.

Extensive debridement under general anesthesia followed by primary open reduction and internal or external fixation for open injuries is recommended

For internal fixation, a vigorous debridement is performed to clear every potential source of infection.

The treatment needs to be individualized depending upon patient profile and wound.

Antibiotic therapy should be started intravenously in the emergency department after the wound has been cultured and should be continued during and after surgery. Tetanus prophylaxis should be provided.

Popularity: 1% [?]

Related posts:

1. Fractures of Forearm Bones – Operative Methods of Treatment
2. Radiograph Fracture of Both Bones of forearm
3. Fractures of Shaft Radius and Ulna – Clinical Presentation, Radiography and Diagnosis
4. Posttraumatic Radioulnar Synostosis Follwing Forearm Fractures
5. Treatment of Fractures of Radius and Ulna