Open Tibia Fractures Workup

  • Author: Minoo Patel, MBBS, MS, FRACS; Chief Editor: Carlos J Lavernia, MD, FAAOS   more...
 
Updated: May 23, 2011
 

Laboratory Studies

  • Routine preoperative blood tests are ordered.
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Imaging Studies

  • Routine limb, chest, and cervical spine radiographs are ordered.
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Proceed to Treatment & Management
 
 
Contributor Information and Disclosures
Author

Minoo Patel, MBBS, MS, FRACS  Senior Lecturer, Monash University; Director, Centre for Limb Reconstruction and Deformities, Epworth Centre, Melbourne, Australia; Orthopaedic Adult/Pediatric Surgeon, Epworth Hospital, Melbourne, Australia; Consulting Adult/Pediatric Orthopedic Surgeon, Department of Orthopedic Surgery, Monash Medical Center, Australia

Minoo Patel, MBBS, MS, FRACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, AO Foundation, Australian Association of Surgeons, Australian Medical Association, Australian Orthopaedic Association, Bombay Orthopedic Society, Indian Orthopedic Association, Orthopaedic Research Society, Orthopaedics Overseas, and Royal Australasian College of Surgeons

Disclosure: Nothing to disclose.

Coauthor(s)

John Herzenberg, MD, FRCSC  Head of Pediatric Orthopedics, Director of International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore

John Herzenberg, MD, FRCSC is a member of the following medical societies: American Academy for Cerebral Palsy and Developmental Medicine, American Academy of Orthopaedic Surgeons, Limb Lengthening and Reconstruction Society ASAMI-North America, and Pediatric Orthopaedic Society of North America

Disclosure: Smith and Nephew, EBI, Orthofix Educational Grant None

Specialty Editor Board

Dennis P Grogan, MD  Clinical Professor, Department of Orthopedic Surgery, University of South Florida College of Medicine; Chief of Staff, Department of Orthopedic Surgery, Shriners Hospital for Children of Tampa

Dennis P Grogan, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Medical Association, American Orthopaedic Association, American Orthopaedic Foot and Ankle Society, Eastern Orthopaedic Association, Irish American Orthopaedic Society, Pediatric Orthopaedic Society of North America, and Scoliosis Research Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: eMedicine Salary Employment

Shepard R Hurwitz, MD  Executive Director, American Board of Orthopaedic Surgery

Shepard R Hurwitz, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association for the Advancement of Science, American College of Rheumatology, American College of Sports Medicine, American College of Surgeons, American Diabetes Association, American Orthopaedic Association, American Orthopaedic Foot and Ankle Society, Association for the Advancement of Automotive Medicine, Eastern Orthopaedic Association, Orthopaedic Research Society, Orthopaedic Trauma Association, and Southern Orthopaedic Association

Disclosure: Nothing to disclose.

Dinesh Patel, MD, FACS  Associate Clinical Professor of Orthopedic Surgery, Harvard Medical School; Chief of Arthroscopic Surgery, Department of Orthopedic Surgery, Massachusetts General Hospital

Dinesh Patel, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons

Disclosure: Nothing to disclose.

Chief Editor

Carlos J Lavernia, MD, FAAOS  Adjunct Clinical Professor, Department of Orthopedic Surgery, University of Miami School of Medicine; Medical Director, Orthopedic Institute at Mercy Hospital

Carlos J Lavernia, MD, FAAOS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association of Hip and Knee Surgeons, Arthritis Foundation, Biomedical Engineering Society, Florida Orthopaedic Society, and Orthopaedic Research Society

Disclosure: Zimmer Stock Implant Designer

References

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Open tibial fracture.
Table 1. Gustilo-Anderson Classification of Open Fractures
TypeWound DescriptionOther Criteria
I< 1 cm (so-called puncture wounds)
II1-10 cm
IIIA>10 cm, coverage availableSegmental fractures, farm injuries,



or any injury occurring in a highly contaminated environment



High-velocity gunshot injuries



IIIB10 cm, requiring soft tissue coverage procedurePeriosteal stripping
IIICWith vascular injury requiring repair
Table 2. Tscherne Classification of Soft Tissue Injuries
GradeSoft Tissue Injury



(Superficial)



Soft Tissue Injury



(Deep)



Compartments
0Absent or negligibleAbsent or negligibleSoft and/or normal
1Superficial abrasionContusion from withinSoft and/or normal
2Deep contaminated abrasionSignificant contusionImpending compartment syndrome
3Crushed skin, subcutaneous avulsionsCrushed devitalized muscleCompartment syndrome
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