The aims of management of an open fracture of the tibia and fibula are:
Gustilo grade I are closed primarily and treated as a closed fracture.
More serious injuries are cleaned, debrided, left open and inspected at day 3. Further debridement may be required.
External fixation is important in stabilising these fractures.
When the wound is clearly clean and granulating it is closed.
Once the fracture has begun to heal the external fixator is replaced by a full cast.
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