Historically, limb-and-life threatening injuries were only generated by warfare and natural catastrophes, but the industrial and technological advances of the past 200 years has exposed the human body to forces that the cannot be withstood. Approximately 60% of open fractures are associated with other major injuries to central nervous system, cardiothoracic and abdominal injuries, or other fractures or musculoskeletal injuries.1

Open fractures pose difficult problems in polytraumatized patients secondary to their emergent need to adequately debride them to prevent infection and possible sepsis. Severe open fractures can certainly be limb- and possibly even life-threatening injuries. The entire trauma team must then communicate effectively regarding needs for surgical intervention and the risks for general anesthesia pending patient status.

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