If the fracture is accompanied by severe soft tissue injury, stabilization of the fracture with an external fixation device facilitates wound care. An external fixation device will many times need…

Gas gangrene may develop when a contaminated open fracture is inadequately debrided. The infection tends to involve the subcutaneous tissue and muscles, sometimes sparing blood vessels, nerves, and bone. Once…

Classification of Open Fracture. Open fractures are graded by the severity of soft tissue damage, fracture pattern, and degree of contamination, as defined by Gustilo and Anderson (see Plate 9-3)….

Radial Nerve Palsy. The radial nerve is the most commonly damaged nerve after fractures of the distal shaft of the humerus. Normally protected in the spiral groove of the humeral…

The goal of treatment is to eliminate the draining sinuses and produce a functional limb that is free from pain. The complicated process just described to eradicate a focus of…

Marrow emboli have been identified in the lungs of patients, leading to the term fat embolism syndrome, but ARDS may also develop in the absence of fracture marrow emboli. Studies…

Treatment of chronic osteomyelitis requires removal of all infected, necrotic bone and all metal foreign bodies; debridement of all necrotic soft tissue; and marsupialization of the necrotic, infected bed. Stability…

ETIOLOGY OF EXOGENOUS OSTEOMYELITIS Exogenous (nonhematogenous) osteomyelitis results from the direct contamination of the bone by the infecting organism. The skin, subcutaneous tissue, and periosteum provide a protective barrier to…

Although the many exogenous causes of osteomyelitis vary greatly, the resulting bone infections share some common characteristics. The bone becomes infected because the protective skin and periosteal barriers have been…

Radiographs of the painful area should be obtained, although radiographic signs are often minimal early in the infection. The earliest radiographic evidence of acute hematogenous osteomyelitis is swelling of soft…