A number of musculoskeletal injuries are considered emergent. Missing these injuries is likely to lead to significant disability, and in some instances possibly death. While many such topics are covered throughout this book, it is important to take a moment to cover some of the most significant topics that warrant special attention.

Delayed diagnosis of an open fracture leads to an increased risk of infection, morbidity including possible loss of limb, and even possible mortality. Any wound in conjunction with a fracture should be considered an open fracture if the dermis is violated. Early treatment with antibiotics is a key factor, and the first line is typically cefazolin, a first-generation cephalosporin. This can be augmented per institutional protocols in the setting of contaminated wounds or severe soft tissue injury. By being quick to refer to a fracture as “open,” and letting the definitive exploration take place during an irrigation and debridement in a formal operating room, fewer missed injuries are likely to occur.