A 35-year-old cyclist has an open tibial fracture contaminated with road debris. Distal pulses are present and tetanus immunization is uncertain.

Question

A 35-year-old cyclist has an open tibial fracture contaminated with road debris. Distal pulses are present and tetanus immunization is uncertain. Which of the following is the most appropriate initial management?

Accepted Answer

Cover, splint, give early IV antibiotics and tetanus prophylaxis, then arrange operative debridement

Answer

Reduce and splint the fracture, then give IV antibiotics after orthopaedic assessment

Answer

Apply negative-pressure wound therapy before antibiotic and tetanus assessment

Answer

Obtain operative cultures before administering systemic antibiotics

Answer

Irrigate extensively in the emergency department, close primarily and give oral antibiotics

Open fracture — MCCQE Part 1 MCQ

A 35-year-old cyclist has an open tibial fracture contaminated with road debris. Distal pulses are present and tetanus immunization is uncertain. Which of the following is the most appropriate initial management?