A 33-year-old has an open tibial fracture contaminated with soil. DP pulse is present, foot sensation is intact, and bleeding is controlled. Tetanus

Question

A 33-year-old has an open tibial fracture contaminated with soil. DP pulse is present, foot sensation is intact, and bleeding is controlled. Tetanus status is uncertain. What is the most appropriate next step?

Accepted Answer

Provide analgesia, sterile dressing, limb alignment/splinting, early IV antibiotics, tetanus prophylaxis and orthopaedic consultation

Answer

Discharge with oral antibiotics after splinting

Answer

Close the wound tightly in the ED before antibiotics

Answer

Delay antibiotics until operative cultures are taken

Answer

Irrigate aggressively with tap water and avoid splinting

Open tibial fracture — RCPSC EM MCQ

A 33-year-old has an open tibial fracture contaminated with soil. DP pulse is present, foot sensation is intact, and bleeding is controlled. Tetanus status is uncertain. What is the most appropriate next step?