Fractures with open joint injuries
When an open fracture communicates with a joint cavity, special surgical tactics are required.
As always, all devitalized tissue must be removed. Joint surfaces should not be allowed to become dry.
If possible, the open joint itself should be closed primarily. If this is not possible, the joint must be kept clean and moist (moisture-retaining dressing). Negative pressure wound therapy (NPWT) or VACs cannot be used over top of a joint.
Early definitive closure should be planned.