ABSTRACT
Fractures may be open or closed. 1. Closed (simple) fracture. A fracture with no communication with the exterior of the body. A fracture may be associated with a wound, but if the two do not communicate then the fracture is not compound. Infection in such an instance can only arise by haematogeneous spread. This is rare. The haematoma in a closed fracture is contained and blood loss is minimized. 2. Open (compound) fracture. A fracture which communicates with the exterior of the body via a wound. The communication may occur because the bone fragment has pierced the skin (within-out) or because an external object has opened the wound up down to the level of the fracture (without-in). Open fractures may become infected due to entry of
organisms from the exterior. Because blood can exit via the wound, blood loss may be significant.
