(ii) Open fractures

Open fractures remain a significant cause of morbidity and, despite improvements in practice, unresolved questions and significant challenges in management remain. Much of the evidence base derives from work on open tibial fractures, which can be considered a worst case scenario since the risks of both non-union and infection in these injuries is particularly high. Evidence based guidelines exist for the management of open tibial fractures and much of this work can be extrapolated to include other open injuries. This article aims to present a comprehensive overview of open fracture assessment and management with reference to the available evidence and current controversies.