Tratamiento de emergencia en fracturas expuestas en pacientes de 30 a 70 años en el Hospital IESS Teodoro Maldonado Carbo desde septiembre 2024 hasta agosto 2025.

Abstract

Introduction: Open fractures are injuries in which the bone is exposed to the outside; their priority treatment consists of resuscitation, stabilization, and immediate reduction of the fracture, evaluating associated vascular complications. Objective: To identify the emergency treatment for open fractures at the IESS Teodoro Maldonado Carbo Hospital from September 2024 to August 2025. Methodology: This study has a non-experimental, observational, descriptive, retrospective, and cross-sectional design. Results: A total of 152 patients with open fractures. Men predominated (114; 75.0%), as did those from urban areas (107; 70.4%) and those aged 30-42 (87; 57.2%). The main mechanism was traffic accidents (98; 64.5%). The most frequent classification was Gustilo-Anderson IIIA (52; 34.2%). The fractures were mainly located in the tibia/fibula (64; 42.1%), followed by the femur (31; 20.4%) and radius/ulna (21; 13.8%). The most common complication was surgical wound infection (47; 30.9%), followed by delayed union (28; 18.4%) and pseudoarthrosis (16; 10.5%). Treatment included surgical cleaning and debridement (149; 98.0%), broad-spectrum antibiotics (134; 88.2%), external fixation (123; 80.9%), and temporary immobilization with a splint or cast (87; 57.2%). Conclusion: Open fractures mainly affect young urban men, with type IIIA fractures of the tibia and fibula predominating due to traffic accidents, with frequent complications such as infection and delayed healing, treated by debridement, antibiotics, and external fixation.