A compound or ‘open’ injury refers to an injury in which a fracture or similar injury is associated with a break in the skin which exposes the underlying architecture of bone, muscle and ligament.
Compound injuries are associated with a high risk of infection and are often accompanied by very significant soft tissue and vascular damage.
A compound injury is distinguished by a visible open wound at the site of injury and is, typically, extremely painful as a result of associated soft tissue damage.
It can also be accompanied by significant bleeding and swelling, as well as deformity in the affected limb.
Compound injuries are commonly the result of high-impact events which deliver enough force to both break bone and tear the skin.
These can include car accidents and falls from height, as well as contect sports like rugby or hockey, and extreme sports such as skateboarding, motocross or rock climbing. Industrial or construction accidents involving heavy machinery are also a major contributor.
The risk of compound injury is increased in individuals with poor quality and fragile bone, who may suffer a compound injury even with relatively little force.
Compound injuries will invariably require surgical intervention, though in advance of surgical intervention you, or a trained medic, may attempt to clean the wound with saline and apply a sterile dressing.
The surgical treatment options for compound injury include:
Reduction and fixation: this involves directly accessing and realigning the damaged bone (open reduction) and internal fixation using plates, screws or rods to maintain proper position during the healing process. External fixation, in which an external frame fitted across the site of injury is used to hold the bones in position, may also be employed, especially where there is significant soft tissue damage.
Bone grafting: involves the implantation of a graft from the patient’s own body (autograft) or a donor (allograft) to support healing and new bone growth where bone loss due to injury is extensive.
Soft tissue reconstruction: involves the repair and reconstruction of soft tissue, muscles, tendons and ligaments damaged by injury, including through the use of skin grafts or muscle flaps.
Amputation: where the limb cannot be salvaged, amputation may be neccessary as a life-saving procedure, or to provide a better quality of life following recovery. In these cases, osseointegration may be used to restore function and TMR and RPNI can be used to minimise residual limb sensation.
For more information or to book a consultation to assess whether surgery is right for you, please contact Professor Al Muderis’ office at +61 2 88829011 or book an appointment online.