by James Hubbard, M.D., M.P.H.

I hope you never see one, but an open fracture, also called a compound fracture, is a broken bone that’s exposed to the air. Proper treatment for an open fracture is essential.

Open fractures are easy to diagnose and pretty dramatic if the bone is sticking out of the skin, or there’s a big cut with a broken bone exposed. But it’s not always that simple. What if you broke a bone and there’s a cut nearby? Could the bone have punctured the skin and then gone back in? The answer is yes.

And if exposed to bacteria, bones can get infected. Infections in open fractures are very hard to cure. You can lose a limb, or your life. Oral antibiotics often don’t work. So you need try your best to prevent the bone from ever becoming infected.

How?

Err on the side of caution.

If you have a wound and suspect a broken bone in the area of the wound, treat it as an open fracture. You can’t be certain that in the initial injury the bone might have poked its way out. Even a millisecond of bone exposure is significant.

Get professional medical treatment right away (if at all possible).

If that’s impossible, then:

  • Irrigate the wound vigorously and thoroughly with water.
  • Instead of an using an average of 4 ounces of water per inch of wound, use 10 or 20 ounces or more. As much as you can spare.
  • Keep the cut edges open. Don’t tape or stitch the cut closed. Just keep it covered. Use antibiotic ointment or honey, if available. Because …
  • You need to re-irrigate the cut once or twice a day.
  • Start antibiotics, if available.