Open Fractures
How We Can Help You for Open Fractures
The board-certified orthopaedic specialists in the Level 1 Trauma Center of Stanford Health Care have extensive experience treating people with an open fracture. Also known as a compound fracture, an open fracture is a broken bone that pierces the skin, leaving an open wound.
The members of our multispecialty team develop a complete, compassionate care plan customized to your condition. The goal is to help relieve your symptoms, which may include a gash, tear, or puncture in the skin, with the bone visible or sticking through it.
Beyond relieving symptoms, your personalized care plan is designed to repair your bones, close wounds, prevent infection, and set you on a path to full recovery.
In addition, Stanford Health Care patients with an open fracture may have opportunities to participate in research studies of new treatment approaches not yet available anywhere else.
What We Offer You for Open Fractures
- Center of Excellence for advanced care of open fractures and the full range of orthopaedic conditions.
- Nationally recognized expertise in treating all open fracture cases, no matter how complex.
- Precise diagnosis including a thorough physical exam plus use of the latest imaging technology, such as computerized tomography (CT) scans.
- Team-based treatment planning that brings together orthopaedic trauma surgeons, rehabilitation specialists, physical therapists, and other dedicated professionals to tailor care to your needs.
- Advanced treatment options emphasizing nonsurgical approaches such as medication and physical therapy. When needed, we also offer minimally invasive surgical procedures performed by highly skilled orthopaedic trauma surgeons.
- Comprehensive support services including care coordination from diagnosis to treatment to follow-up.
- Active research program to develop new diagnostic and treatment advances to help people with open fractures.
Treatment for Open Fractures
An open fracture (or compound fracture) refers to a broken bone that causes an open wound or break in the skin. This type of traumatic injury requires emergency treatment to set the bone and prevent infection in the wound. If you have a broken bone, see your doctor right away.
Stanford Level 1 Trauma Center provides the highest level of care for open fractures. Our orthopaedic trauma surgeons have advanced training and expertise in diagnosing and treating these injuries.
We specialize in nonsurgical and surgical techniques to repair bones, close wounds, and prevent or fight off infection. Our skilled surgical team and rehabilitation specialists can set you on your way to a full recovery.
At Stanford Level 1 Trauma Center, you can count on the highest quality of care from our orthopaedic trauma specialists.
Medication
Simple Fractures
Complex Fractures
Physical Therapy
Medication
Open fractures can quickly become infected when bacteria enter the wound and spread through skin, soft tissue, and bone. We typically start your treatment by prescribing antibiotics to prevent or fight off infection.
Which antibiotic your doctor uses depends on how severe your wound is and what type of bacteria has infected it. The bacteria that cause tetanus (a painful infection also called lockjaw) can enter through an open wound. So, you may also need a booster shot to bring your tetanus vaccination up to date.
Treating Simple Open Fractures
Treating any open fracture involves setting the broken bone, cleaning the wound, and closing it to prevent contamination. Your orthopaedic trauma team will use these procedures to care for less severe open fractures:
Debridement and irrigation: We clean the wound, removing any foreign material and damaged tissue (a process called debridement). Then we irrigate the wound by washing it out thoroughly with a sterile saline solution to prevent infection.
Internal fixation: We use this procedure if you have a clean wound, minimal skin damage, and pieces of bone that align well together. Your surgeon inserts metal plates, rods, or screws inside the broken bone to hold it together while it heals. You will wear a sling, cast, or splint to keep your injured limb immobile while the fracture heals.
Treating Complex Open Fractures
Some open fractures cause a large wound, significant skin or soft tissue loss, and a bone that’s broken in multiple places. For these injuries, we take extra steps to repair damage and reduce the risk of infection. In addition to debridement and irrigation, you may have:
External fixation: If the open fracture is severe, we may insert metal screws into the bone above and below the fracture to stabilize the bone. The screws extend out of the skin and attach to bars outside the body. Usually, your doctor will replace the external fixation with internal fixation as soon as it’s safe to do so.
Skin grafts: If you’ve lost skin around the wound, you may need a skin graft. Your surgeon transplants healthy skin from another part of your body to cover the wound.
Free flap: If a local flap isn’t an option, your surgeon will transfer tissue from elsewhere on your body, often your back or abdomen. We work with a microvascular surgeon who specializes in small blood vessels to ensure proper blood flow to the transferred tissue.
Temporary dressings: If your wound is too large to close, your doctor may seal it with temporary dressings to prevent infection. We may place small beads of antibiotics onto the wound. Then we cover the wound with a semipermeable dressing that blocks bacteria but allows oxygen to flow through.
Local flap: If you also injured the muscle around the wound, we can rotate nearby muscle tissue into the wound to cover it. Then your surgeon can cover the flap with a skin graft.
Physical Therapy
As you recover from surgery, a physical therapist will help you regain strength and improve mobility. The board-certified specialists at Stanford’s Physical Medicine and Rehabilitation Clinic are experts at helping you return to full function. They will guide you through exercises to speed your recovery and prevent complications as you heal.
Medication
Open fractures can quickly become infected when bacteria enter the wound and spread through skin, soft tissue, and bone. We typically start your treatment by prescribing antibiotics to prevent or fight off infection.
Which antibiotic your doctor uses depends on how severe your wound is and what type of bacteria has infected it. The bacteria that cause tetanus (a painful infection also called lockjaw) can enter through an open wound. So, you may also need a booster shot to bring your tetanus vaccination up to date.
close Medication
Treating Simple Open Fractures
Treating any open fracture involves setting the broken bone, cleaning the wound, and closing it to prevent contamination. Your orthopaedic trauma team will use these procedures to care for less severe open fractures:
Debridement and irrigation: We clean the wound, removing any foreign material and damaged tissue (a process called debridement). Then we irrigate the wound by washing it out thoroughly with a sterile saline solution to prevent infection.
Internal fixation: We use this procedure if you have a clean wound, minimal skin damage, and pieces of bone that align well together. Your surgeon inserts metal plates, rods, or screws inside the broken bone to hold it together while it heals. You will wear a sling, cast, or splint to keep your injured limb immobile while the fracture heals.
close Simple Fractures
Treating Complex Open Fractures
Some open fractures cause a large wound, significant skin or soft tissue loss, and a bone that’s broken in multiple places. For these injuries, we take extra steps to repair damage and reduce the risk of infection. In addition to debridement and irrigation, you may have:
External fixation: If the open fracture is severe, we may insert metal screws into the bone above and below the fracture to stabilize the bone. The screws extend out of the skin and attach to bars outside the body. Usually, your doctor will replace the external fixation with internal fixation as soon as it’s safe to do so.
Skin grafts: If you’ve lost skin around the wound, you may need a skin graft. Your surgeon transplants healthy skin from another part of your body to cover the wound.
Free flap: If a local flap isn’t an option, your surgeon will transfer tissue from elsewhere on your body, often your back or abdomen. We work with a microvascular surgeon who specializes in small blood vessels to ensure proper blood flow to the transferred tissue.
Temporary dressings: If your wound is too large to close, your doctor may seal it with temporary dressings to prevent infection. We may place small beads of antibiotics onto the wound. Then we cover the wound with a semipermeable dressing that blocks bacteria but allows oxygen to flow through.
Local flap: If you also injured the muscle around the wound, we can rotate nearby muscle tissue into the wound to cover it. Then your surgeon can cover the flap with a skin graft.
close Complex Fractures
Physical Therapy
As you recover from surgery, a physical therapist will help you regain strength and improve mobility. The board-certified specialists at Stanford’s Physical Medicine and Rehabilitation Clinic are experts at helping you return to full function. They will guide you through exercises to speed your recovery and prevent complications as you heal.
close Physical Therapy
INTERESTED IN AN ONLINE SECOND OPINION?
The Stanford Medicine Online Second Opinion program offers you easy access to our world-class doctors. It’s all done remotely, and you don’t have to visit our hospital or one of our clinics for this service. You don’t even need to leave home!
Visit our online second opinion page to learn more.
Clinical Trials
Clinical trials are research studies that evaluate a new medical approach, device, drug, or other treatment. As a Stanford Health Care patient, you may be eligible to participate in open clinical trials.
Open trials refer to studies that are currently recruiting participants or that may recruit participants in the near future.
What is an Open Fracture?
Our Clinics
At Stanford Level 1 Trauma Center, our orthopaedists have the expertise to diagnose and treat even the most complex open fractures. We use advanced surgical techniques to repair your bones, prevent infection, and put you on the road to healing.
450 Broadway St
450 Broadway StRedwood City, CA 94063
Phone: 650-723-5643 Getting Here
To schedule an appointment, please call 650-723-5643.