Abdur Rahman Qureshi, Jugdesh Kumar, Aftab Alam Khanzada, Syed Muhammad Awais.
Frequency of causes and location of open fractures.
Pak J Med Health Sci Jan ;6(1):13-5.

Open fractures are high-energy injuries that require a principle-based approach, starting with detailed evaluation of patient status and injury severity. In the presence of extensive soft tissue damage, local or free muscle flaps should be transferred to achieve coverage. Stable fracture fixation should be achieved with a method suitable for the bone and soft tissue characteristics. Early bone grafting is indicated for bone defects unstable fractures treated with external fixation, and delayed union. Management of the infected open fracture is based on radical débridement, skeletal stabilization, microbial-specific antibiotics, soft-tissue coverage, and reconstruction of bone defects. The objective of the study was common causes and location of open fractures. The study was carried out from September 1995 to 1998 in the Department of Orthopaedics, Mayo Hospital, Lahore. Five hundred patients who have sustained open fractures of upper and lower limbs received within 24 hours after the injury of all ages and both sexes were included. Patients with endocrine disorders and cavities injuries were excluded from the study. The wounds were selected for primary and delayed primary closure on suction drain. The contamination organism was detected by culture swab from the wound prior to debridement and lavage. All these open fractures were followed upto 4 weeks. There were three major causes were noted. Eighty cases of humerus open fracture were caused road traffic accidents 8 by agriculture injury and 2 by fall and fire arms. In case of radius and ulna, 80 cases were of road traffic accident, 8 cases of agriculture and 14 cases of fall and fire arm injury. In 108 femur open fracture, 80 were of road side accidents, 8 were of agriculture and 20 were of fall and fire arms. In 200 open fracture of tibia/fibula, 10 cases were of road side accident, 11 of agriculture and 89 were of fall and fire arms injury. It is concluded that causes of open fracture were road traffic accidents and location of long bones showed tibia or lower extremity were mostly injured.

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