An open fracture, also known as a compound fracture, is a type of fracture in which there is an open wound or break in the skin near the site of the broken bone. This type of fracture requires different treatment than a closed fracture, in which there is no open wound. Once the skin is broken, bacteria from dirt and other contaminants can enter the wound and cause infection. For this reason, early treatment for an open fracture focuses on preventing infection at the site of the injury. The wound, tissues, and bone must be cleaned out in a surgical procedure as soon as possible. The fractured bone is also usually stabilized with a surgical procedure to allow the wound to heal. Open fractures vary greatly in severity. In many high-energy injuries, there is obvious skin damage, and the bone can be seen protruding through the wound. In other cases, the wound may be no larger than a puncture. In either situation, the damage to the soft tissues around the bone, including muscles, tendons, nerves, veins, and arteries, can be extensive.

Some key points about open fractures include:

• An open fracture is an injury where the fractured bone and/or fracture hematoma are exposed to the external environment via a traumatic violation of the soft tissue and skin.
• Any fracture that has a concomitant wound should be considered open until proven otherwise.
• Open fractures occur secondary to trauma, and they most commonly occur as high-energy injuries, but can also be a result of low-velocity trauma when the sharp ends of the fracture fragments pierce through the skin and soft tissue.
• Open fractures require definitive operative intervention.
• Compound fractures are urgent situations because of the high risk of infection, tissue damage, and healing complications.
• Open fractures become infected much more commonly than similar fractures that are not open.
• Patients with open fractures should be transported by ambulance, if possible, to the nearest trauma center emergency room to initiate appropriate treatments.
• The underlying damage to bone, muscles, blood vessels, and other structures can be extensive, and the risk of infection greatly complicates treatment for an open fracture.