Skip to main content

Fracture, Open, Emergency Medicine

Christy Rosa Mohler Reviewed 06/2017



  • Continuity between skin violation and fracture site, ranging from a puncture wound to grossly exposed bone

  • Surgical urgency, as delays in care increase risk of infection and rate of c...


Signs and Symptoms

  • Deformity with nearby violation in skin integrity

  • Neurovascular compromise may occur.

  • Additional traumatic injuries are frequently present.


Significant trauma 

Physical Exam



  • Moist, sterile dressings over open wounds

  • Immobilize joints above and below fracture.

  • Control bleeding with local compression.

  • Consider tourniquet for traumatic amputations or uncon...



Admission Criteria

Most patients will be admitted for irrigation, débridement, IV antibiotics, and possibly operative fixation. 

Discharge Criteria

Simple open fractures may be washe...

Pearls and Pitfalls

  • Open fractures are surgical urgencies requiring prompt orthopedic consultation.

  • 40–70% of patients with open fractures have other traumatic injuries.

  • Prompt and thorough ED assessmen...

Additional Reading

  • Bucholz  RW, Heckman  JD, Court-Brown  CM, Tornetta  P. Rockwood and Green's Fractures in Adults, 7th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2010.

  • Hauser CJ, Adam...



  • 818.1 Ill-defined open fractures of upper limb

  • 827.1 Other, multiple and ill-defined fractures of lower limb, open

  • 829.1 Fracture of unspecified bone, open

  • 828.1 Open multiple fractures involvi...

Subscribe to Access Full Content

Sign Up for a 10-Day Free Trial

Sign up for a 10-day FREE Trial now and receive full access to all content.