Pediatric Guidelines
Open Fractures

Open Fractures

Inclusion Criteria

Physical examination consistent with open fracture: 

  • Radiographic evidence of a fracture, PLUS 
  • Laceration located superficial or adjacent to fracture location

Consult

Consult Orthopaedic Resident On Call

If skull fracture: consult neurosurgery resident on call (abx & tetanus prophylaxis considerations remain similar)

Antibiotic Prophylaxis

Dosing assumes normal renal function

Administer IV antibiotics within 1 hour of presentation

Wound ≤1 cm and minimal soft tissue damage

Wound 1-10 cm and moderate soft tissue damage

Wound >10 cm and extensive soft tissue damage

  • Adequate soft tissue coverage
  • Requiring flap coverage
  • Requiring vascular repair

More Information

The clinical pathways are based upon current, available evidence. The clinical pathways should not be used as medical advice. They should be used as a guide in managing patients. In addition to the clinical pathway, medical management is to be individualized, and may depend on medical resources available to the medical practitioners, the physician’s clinical judgment and any special circumstances pertaining to the patient and/or family. They are not intended to establish a standard of care. Although the pathways are developed after careful deliberation, they cannot be guaranteed to be completely accurate or without omissions. UCLA is not responsible for any unexpected or adverse patient events or outcomes in connection with the application of the clinical pathways to patient management. Readers are encouraged to confirm the information contained within the clinical pathways with other references, sources and expert opinion prior to instituting a health care decision for patient care.

Approval Date: October 13th, 2021

Next Revision Date: October 13th, 2023