Vol. 7, Issue 1, Part A (2025)

Open fractures are a major clinical concern due to the likely complications such as infection, nonunion, and disability. Most of the time these types of fractures happen with high-energy trauma caused by car accidents, falls from height, or industrial accidents. Although trauma care has improved over time, there continues to be practice variation in the evaluation and management of open fractures across different institutions and health care settings. Therefore, the aim of this multicenter study was to describe current evaluations, and challenges, in the management of open fractures by investigating the diagnosis pathways, treatment approaches, and patient-directed outcomes through five regional tertiary care centers over a two-year period. A total of 100 patients with Gustilo-Anderson categorized open fractures were included in the analysis. Variables included in the analysis, and results included time to first debridement, antibiotic protocols, fracture classification systems, use of surgical techniques (internal fixation, external fixation), and functional recovery measures. Our findings revealed very different practice patterns related to the treatment of open fractures, especially timing of antibiotics and the timing of interventions and to determine the need for standardized guidelines to improve clinical outcomes. There were also high complication rates for patients with severe fractures (Type IIIB and IIIC) which highlights the importance of early multidisciplinary input (plastic surgery, vascular surgery, and infectious disease) in the care of patients with open fractures. Likewise, socioeconomic factors played an important role in establishing recovery indicators, such as range of motion, pain scores, and return to work. The manuscript includes six tables that highlight the key data regarding demographics, treatments, complications rates, and functional recovery measures for the patients. Together, these findings provide important data about hospital-based open fracture care and point to areas where improvements can be made, including the development of consensus-based protocols, resource allocation, and interventions to mitigate socioeconomic factors. Future studies need to focus on predictive models of complications, and consider novel methods to improve long-term functional outcomes, including telemedicine and personalized rehabilitation programs.