Treatment of isolated type I open fractures: is emergent operative debridement necessary?

A retrospective review was done of treatment of isolated Type I open fractures. Ninety-one patients with isolated Type I open fractures were included in the study. Patients with multiple injuries, gunshot wounds, hand injuries, compartment syndromes, intraarticular fractures, or higher type open fractures were excluded. All patients received antibiotics and were followed up until fracture union. The patients' charts were reviewed for the type of fracture, mechanism of injury, type of treatment, length of hospital stay, and complications encountered, especially infections. There was a 0% incidence of infection in all patients. Only one patient received operative debridement within 12 hours. A prospective randomized study of the treatment of Type I open fractures is needed to determine whether immediate operative debridement is necessary to prevent infection. Immediate operative debridement may not be necessary in the isolated, low-energy Type I open fracture with stable fracture patterns.