External fixation is often used in open fractures for several reasons that relate to the specific characteristics and challenges associated with these types of fractures:
- Infection Control:
- Open fractures involve a break in the skin, exposing the fractured bone to the external environment. This significantly increases the risk of infection. External fixation allows for stabilization of the fracture without the need for internal hardware, reducing the risk of infection associated with implanted devices.
- Wound Access and Care:
- External fixators provide easy access to the open wound, allowing healthcare providers to perform wound care and monitor the healing process. This access is crucial for preventing and managing infections that may arise from contamination at the site of the open fracture.
- Minimization of Soft Tissue Disruption:
- Internal fixation methods, such as plates and screws, require additional dissection of soft tissues to implant the hardware. External fixation minimizes soft tissue disruption because it involves placing pins or wires through the skin into the bone without extensive exposure. This approach is particularly beneficial when there is already soft tissue damage in the area of the open fracture.
- Immediate Stabilization:
- External fixators allow for immediate stabilization of the fracture, reducing the risk of further injury and facilitating early mobilization. This is important in cases of open fractures where delays in stabilization could lead to complications.
- Facilitation of Wound Healing:
- External fixation does not interfere with the wound as much as internal fixation methods do. This can promote better wound healing by minimizing trauma to the already compromised soft tissues.
- Flexibility and Adjustability:
- External fixators offer the flexibility to make adjustments during the healing process. This is important in managing complex fractures and accommodating changes in the alignment of the bone over time.
- Orthopedic Damage Control:
- In cases of polytrauma or critical injuries, where a patient has sustained multiple life-threatening injuries, external fixators may be applied as part of orthopedic damage control. This involves quickly stabilizing fractures to prevent further harm while other life-saving interventions are performed.
- Non-Surgical Candidates:
- External fixation can be employed in situations where immediate surgical intervention is not feasible or when a patient is not a suitable candidate for internal fixation surgery.
In summary, the use of external fixation in open fractures is driven by the need to minimize infection risks, provide access for wound care, reduce soft tissue disruption, and enable immediate stabilization. It is a valuable technique that addresses the unique challenges associated with fractures where the bone is exposed to the external environment.
