Système orthopédique et musculaire : recherche actuelle
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Open Lower Limb Fractures-Management and Treatment Algorithm

Frederico Paiva, Bruno Pombo, Rita Santos, Vânia Capelão and Horácio Costa

An open fracture is defined as a fracture which associates a continuity solution that communicates with the fracture site or its hematoma. They are associated with great morbidity and motor dysfunction. Lower limb open leg fractures are more severe than upper limb fractures due to tissue damage and increased frequency of associated brain lesion. The femur is usually affected in the context of high energy trauma and hence it tends to occur in polytraumatized patients.

As these fractures present high severity, the treatment must be multidisciplinary with plastic surgery, orthopedics and vascular surgery since different tissues are involved in the trauma. The orientation of the patient and the different priorities to take non-therapeutic treatment over the last few years has developed. The transaction should be done in the centers of the diagnosis of vascular reconstruction, schematic stabilization, debridement and reconstruction of the soft tissue and bone.

The aim of this article is to review the criticism regarding the treatment of open fractures of the lower limb with respect to global assessment, vascular evaluation, debridement, antibiotic therapy, compartment syndrome, skeletal stabilization and reconstruction of soft tissues and bone.