Soft-tissue trauma

Abstract

The simple classification as open or closed seem to be the only universally accepted scheme but is not enough for therapeutic decision making, quality control, and scientific comparison of different soft-tissue lesions.Closed fractures are divided into four grades of severity according to Tscherne and Oesterb, whereas open fractures are classified into three grades and three subgrades accordibg to Gustilo and Anderson. The simple classification as open or closed seem to be the only universally accepted scheme but is not enough for therapeutic decision making, quality control, and scientific comparison of different soft-tissue lesions.Closed fractures are divided into four grades of severity according to Tscherne and Oesterb, whereas open fractures are classified into three grades and three subgrades accordibg to Gustilo and Anderson. The treatment algorithm of open fractures encloses pimary treatment at the scene (reduction of the fracture, splinting and coverage of the wound).In the emergency room assesment of the patient follows.In the operating room dressings of the wound are removed, wound irrigation and debridement will follow.Stabilization of the fracture is performed either by plate, nail or external fixation.Wound closure can be performed primary or delayed.