Question

A 25-year-old man is brought to A&E after a fall from a ladder. His right leg has an open fracture of the tibia with bone visible and heavy contamination with soil. Distal pulses are present. What is the most appropriate immediate management in the emergency department?

Accepted Answer

Cover the wound with a sterile saline-soaked dressing, give IV antibiotics and tetanus prophylaxis, and arrange urgent orthopaedic review

Answer

Attempt to push the bone back into place and apply a plaster cast

Answer

Leave the wound exposed to air to allow drainage

Answer

Give only oral antibiotics and arrange outpatient review

Answer

Delay antibiotics until after definitive surgical debridement

Practice question

A 25-year-old man is brought to A&E after a fall from a ladder. His right leg has an open fracture of the tibia with bone visible and heavy contamination with soil. Distal pulses are present. What is the most appropriate immediate management in the emergency department?