Open Fractures of the Hand

ABSTRACT: Open fractures of the hand are a challenging clinical problem for the orthopedic surgeon. The fracture is often comminuted with substance loss. Additionally, the fracture site  can be contaminated by foreign material. The soft tissue envelope is violated with a variable  degree of tissue devitalized. The wound contamination and tissue destruction lead to a rate of  infection that can be much higher than that for a closed fracture. Initially, management of a  significant soft tissue injury must take precedence over definitive fracture fixation. Proper  staging of debridement, wound closure, and definitive fixation is paramount in minimizing  infection while obtaining fracture union.