OWL: OCOSH Classification/Trauma/Fractures/Open Fractures

Antibiotics for preventing infection in open limb fractures

Gosselin et al — 2002-02-04 03:40:17 GMT

Summary: Antibiotics are effective in preventing early infection in open fractures of the limbs Wound and bone infections are common complications following open fractures of the limbs. For more than 20 years, in developed countries, the use of antibiotics has been a part of a standard management protocol that also includes irrigation, surgical debridement, and stabilisation when indicated. The review of trials found that antibiotics are effective in decreasing the incidence of wound infections, as compared to no antibiotics or placebo. No studies on bone infection or long-term morbidity were identified. (Cochrane Review)
Gosselin RA, Roberts I, Gillespie WJ. Antibiotics for preventing infection in open limb fractures. Cochrane Database of Systematic Reviews 2004, Issue 1. Art. No.: CD003764.

Microsurgery Transplantation and Replantation Buncke et al

H.J.Bunke (ed) — 2005-08-02 03:40:17 GMT

Full text and illustrations of 1991 textbook

Open Fracture Classification

David C. Templeman, MD — 2002-04-21 03:40:17 GMT

Lecture/Presentation from the Basic Fracture Course of the Orthopaedic Trauma Association

Open Fractures Orthoteers

Not Available — 2008-11-20 03:40:17 GMT

Open (Compound) fractures
Goals
* Prevention of infection
* Healing of the fracture
* Restoration of function
Classification
Steps in Management

Open Fractures Wheeless

C.R.Wheeless — 2002-02-04 03:40:17 GMT

treat all open fractures as an emergency; - perform thorough initial evaluation to diagnose other life-threatening injuries:
Wheeless' Textbook of Orthopaedics

Pulsatile Lavage Irrigation for Removing Particulate Matter from Bone

David Templeman, MD — 2005-09-04 03:40:17 GMT

Medscape 2000 Report
At the current time, it seems most appropriate to use high-pressure lavage systems in the irrigation and debridement of open fractures. It is noted that high-pressure lavage may have adverse effects and that surgeons should be judicious in the amount of fluid that is potentially injected into the soft tissue compartments.

Rationale and Technique of Wound Debridement

Andrew H. Schmidt, MD — 2002-04-21 03:40:17 GMT

Rationale and Technique of Wound Debridement Lecture/Presentation from the Basic Fracture Course of the Orthopaedic Trauma Association

The Decision to Salvage or Amputate Medscape

Hiatt et al — 2007-09-26 03:40:17 GMT

The Decision to Salvage or Amputate a Severely Injured Limb
J South Orthop Assoc 9(1):72-78, 2000 Mark D. Hiatt, MD, MBA, James M. Farmer, MD, Robert D. Teasdall, MD, ScM
Abstract The decision to salvage or amputate a severely injured limb is one of the most difficult an orthopaedic surgeon may face. The inclination to undertake heroic measures to save the limb should be tempered by the realization that doing so may lead to repeated hospitalizations, extensive complications, and a poor functional outcome. Several factors must be considered, including objective elements related to the patient's injury and physical condition and subjective considerations related to the patient's psychologic, social, and economic status. We present a framework, in the context of a case study, which may be used in deciding which patients can benefit from early amputation and review five predictive indices for limb salvage.