Wednesday, January 7, 2015

A Recent Review of How Today's Clinicians Are Treating Fractures


Open fractures are bone fractures in which the bone breaks through the skin, leaving it exposed to the external environment (see figure below for example). As you can imagine, this exposure leaves the fracture particularly vulnerable to infection and other related complications, including an inability of the bone to heal properly. When treating these wounds, the orthopedic treatment teams (surgeons, nurses, and others) attempt to prevent infection using wound classification, prophylactic antibiotics, irrigation, and other methods. Despite these efforts, infections and related complications still plague fracture patients. In a recent publication, my collaborators and I outlined the current paradigms in open fracture treatment, the infectious challenges facing those treatments, and the future of patient care.

This is a pretty cool review and I would recommend checking it out. Unfortunately it is not in an open access journal so you will need to get the article through your local library with a subscription to the journal. The take home points from our paper are outlined below.

An example of an open fracture, as published in our review.
This is a severe open fracture.
  • Open fractures are at an increased risk for infection and related complications.
  • Current treatment aims to prevent infectious complications through wound categorization, prophylactic antibiotic administration, debridement and irrigation, and effective fracture fixation.
  • Culture-based methods offer poor prognostic value, leading to current research on culture-independent methods.
  • Biofilm infection is a significant concern in open fracture treatment, and different hardware coating treatments are
    under development.
  • Treatments involving immune system stimulation are being developed to address the local deficient immune responses of open fractures.

Works Cited

Hannigan, G., Pulos, N., Grice, E., & Mehta, S. (2014). Current Concepts and Ongoing Research in the Prevention and Treatment of Open Fracture Infections Advances in Wound Care DOI: 10.1089/wound.2014.0531

Stock image near top: Source

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