Open fractures are fractures in which the bone has penetrated the skin or remains visible above the skin. They used to be considered one of the few true Orthopaedic emergencies. Recently, however, multiple studies focused primarily on leg/foot open fractures have shown that emergency surgery is not always mandatory.
The main reason to wait is to have more alert surgeons, more alert and specialized operating room staff, and to obtain proper orthopedic equipment. This is often impossible at 3 am, but easy to do at 10 am.
Dr. Catalano’s study was the first to demonstrate that open hand fractures can follow the same treatment as open leg/foot fractures. The study did note that one of the only risk factors for not performing surgery right away is if the patient smokes. This can cause infection which can lead to complications. Another reason to stop smoking!
This study should change the treatment of these common fractures as it demonstrates no increased risk of infection (unless the patient is a smoker) after performing surgery even more than 24 hours after the injury.
*We’d like to be clear that as a patient if you have an open hand fracture, you should go to the ER immediately no matter what time of day it is. It is then up to the on-call surgeon to decide when the surgery will take place.*