Open fracture after a crash: caring for the bone and the wound
How an orthopedic trauma surgeon and a wound care clinician view bone and skin healing
An open fracture is a broken bone linked to a wound in the skin. You may not see the bone at all. The wound gives germs a path to deeper tissue. So care has to fight infection and keep the bone stable. An orthopedic trauma surgeon plans the cleaning and how the bone is held in place. A wound care clinician helps track how the skin and soft tissue heal. [1, 2]
Learn what each stage of treatment involves
Ask what was cleaned during surgery. Find out whether metal hardware or an outside frame holds the bone. Ask if more procedures or skin coverage are planned. Get a clear dressing schedule and a number to call if supplies run out. If you were given antibiotics, take them exactly as prescribed. Ask what to do about a missed dose or side effects. [1]
Protect the wound and the bone together
Ask how much weight the injured arm or leg can take. Find out if a brace or splint stays on and which movements are allowed. Keep the wound clean and dry as your team directed. Do not remove a dressing or adjust pins unless you were taught how. [1, 2]
Watch for new drainage, odor, redness, warmth, swelling or growing pain. Report any of these to your team right away. Infection can appear during healing or later. [1, 2]
Keep every checkup, even when the wound looks good
The wound can look better before the bone is solid. Follow up visits and imaging check that the bone is lined up and healing. Get emergency care for a hand or foot that turns cold or pale. The same goes for new loss of feeling or movement and severe pain you can’t control. A fever with a wound that is quickly getting worse needs emergency care too. Ask which symptoms need a call that same day and which need emergency care. [1]
Questions to ask your surgeon
- Will I need another operation or something to cover the wound?
- What are my rules for dressings, antibiotics and putting weight on the limb?
- When will the bone and the wound each be checked again?
Keep your care plan on a single page
Sources and further reading
- 1American Academy of Orthopaedic Surgeons open fractures
- 2AAOS infection prevention after major extremity trauma
This is general information from the viewpoint of orthopedic trauma and wound care. Follow the surgery, antibiotic, dressing and weight bearing instructions your own team gave you.
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