{"id":45,"date":"2013-05-10T17:14:46","date_gmt":"2013-05-10T21:14:46","guid":{"rendered":"http:\/\/www.bluzeus.com\/orthoblog\/?p=45"},"modified":"2013-05-10T17:27:06","modified_gmt":"2013-05-10T21:27:06","slug":"how-urgent-are-open-fractures","status":"publish","type":"post","link":"https:\/\/www.orthopaediclist.com\/blog\/how-urgent-are-open-fractures\/","title":{"rendered":"How Urgent are Open Fractures?"},"content":{"rendered":"<div id=\"attachment_49\" style=\"width: 210px\" class=\"wp-caption alignright\"><a href=\"http:\/\/www.bluzeus.com\/orthoblog\/wp-content\/uploads\/2013\/05\/Dahners-photo.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-49\" class=\"size-full wp-image-49 \" alt=\"Dahners photo\" src=\"http:\/\/www.bluzeus.com\/orthoblog\/wp-content\/uploads\/2013\/05\/Dahners-photo.jpg\" width=\"200\" height=\"253\" \/><\/a><p id=\"caption-attachment-49\" class=\"wp-caption-text\">Dr. Laurence Dahners<\/p><\/div>\n<p>by Laurence E. Dahners, M.D.<\/p>\n<p>A relatively new factor to consider in the treatment of trauma victims with open fractures is the fact that the data do not support the concept that open fractures are &#8220;emergencies requiring surgical debridement within six hours.&#8221; Initial studies were in pediatric open fracture but recently papers regarding infection rates in adults have been published as well. None of these studies has shown a statistically significant difference in infection rates in fractures debrided in less than six hours as compared to those debrided between six and twenty-four hours. The &#8220;trends&#8221; (non statistical differences) lean toward higher infection rates in those debrided in the first six hours! It does make a huge difference how soon the antibiotics are started so this remains very important. It is difficult to rationalize why early debridement would not lower infection rates but I hypothesize that it may be easier to differentiate necrotic from viable\u00a0tissue when the debridement is carried out after six hours. In any case I now perform debridement during the daylight hours.<\/p>\n<p><i>Dr. Dahners is a Professor of Orthopaedic Surgery at the UNC School of Medicine in Chapel Hill, NC, USA.\u00a0 His clinical focus is on trauma and his research interests are in ligament physiology, ligament healing, ligament growth and contracture, and bone healing and the biomechanics of internal fixation.\u00a0 You can see his \u201cPearls of Orthopaedics\u201d on <a title=\"OrthopaedicLIST\" href=\"http:\/\/www.orthopaediclist.com\" target=\"_blank\">OrthopaedicList.com<\/a>.<\/i><\/p>\n","protected":false},"excerpt":{"rendered":"<p>by Laurence E. Dahners, M.D. A relatively new factor to consider in the treatment of trauma victims with open fractures is the fact that the data do not support the concept that open fractures are &#8220;emergencies requiring surgical debridement within six hours.&#8221; Initial studies were in pediatric open fracture but recently papers regarding infection rates [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6],"tags":[8,7],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>How Urgent are Open Fractures? - OrthopaedicLIST.com Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.orthopaediclist.com\/blog\/how-urgent-are-open-fractures\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"How Urgent are Open Fractures? - OrthopaedicLIST.com Blog\" \/>\n<meta property=\"og:description\" content=\"by Laurence E. Dahners, M.D. A relatively new factor to consider in the treatment of trauma victims with open fractures is the fact that the data do not support the concept that open fractures are &#8220;emergencies requiring surgical debridement within six hours.&#8221; Initial studies were in pediatric open fracture but recently papers regarding infection rates [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.orthopaediclist.com\/blog\/how-urgent-are-open-fractures\/\" \/>\n<meta property=\"og:site_name\" content=\"OrthopaedicLIST.com Blog\" \/>\n<meta property=\"article:published_time\" content=\"2013-05-10T21:14:46+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2013-05-10T21:27:06+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/www.bluzeus.com\/orthoblog\/wp-content\/uploads\/2013\/05\/Dahners-photo.jpg\" \/>\n<meta name=\"author\" content=\"James Hundley, MD\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"James Hundley, MD\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.orthopaediclist.com\/blog\/how-urgent-are-open-fractures\/\",\"url\":\"https:\/\/www.orthopaediclist.com\/blog\/how-urgent-are-open-fractures\/\",\"name\":\"How Urgent are Open Fractures? 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