Open joint injury: Difference between revisions

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==Management==
 
==Management==
 
* Perioperative antibiotics until 24 to 48 hours postoperative
 
* Perioperative antibiotics until 24 to 48 hours postoperative
  +
**No specific risk factors: [[cefazolin]]
  +
**MRSA likely: [[vancomycin]]
  +
**Extensive soft-tissue injury: add gram-negative coverage ([[ceftriaxone]], [[Aminoglycosides|aminoglycoside]], etc)
  +
**Fecal contamination: add high-dose [[penicillin]] (for [[Clostridium]])
  +
**Seawater contamination: add [[doxycycline]] (for [[Vibrio vulnificus]])
 
*See also [[Antibiotic prophylaxis for open fractures]]
 
*See also [[Antibiotic prophylaxis for open fractures]]
   

Revision as of 12:15, 4 April 2022

Classification

  • Type I: single penetration with out extensive soft tissue damage
  • Type II: Single or multiple penetrations with extensive soft tissue distruptions (flapsm avulsions, or degloving)
  • Type III: open periarticular fractures with extension through the adjacent intraarticular surface
  • Type IV: open dislocations or those with associated nerve or vascular injury requiring repair

Management

Further Reading

  • Open joint injuries. Classification and treatment. Clin Orthop Relat Res. 1989(243):48-56. PMID: 2721074