Open Femur Fracture with Soft Tissue Loss
High-grade open femur fractures in pediatric patients are high-energy injuries and 70% of patients have associated injuries. Despite the pediatric nature of the patient, these wounds are at high risk for infection, which can be as high as 50% in type III fractures. Thus, thorough debridement and timely administration of prophylactic antibiotics are essential. Fixation type largely depends on the age of the patient with consideration of the soft tissue injury. Internal fixation with intramedullary fixation, open reduction internal fixation (ORIF), or percutaneous fixation have been shown to have faster time to union than external fixation. These fractures are much slower to heal than closed pediatric femoral fractures, with full union taking potentially up to 32 weeks.
References and Suggested Reading
- FLOW Investigators, Bhandari M, Jeray KJ, Petrisor BA, Devereaux PJ, Heels-Ansdell D, Schemitsch EH, Anglen J, Della Rocca GJ, Jones C, Kreder H, Liew S, McKay P, Papp S, Sancheti P, Sprague S, Stone TB, Sun X, Tanner SL, Tornetta P 3rd, Tufescu T, Walter S, Guyatt GHA (2015) Trial of wound irrigation in the initial management of open fracture wounds. N Engl J Med 373(27):2629–2641CrossRefGoogle Scholar