EXTERNAL FIXATION

OPEN FRACTURE MANAGEMENT

Procedure: 

• Position the patient supine under spinal anesthesia
• Skin antisepsis by betadine scrubbing and draping 
• Lavage with normal saline and hydrogen peroxide
• Remove foreign body and necrosis tissues / infected tissues 
• Irrigate and debride the wound 
• Bone reduction and stabilization of the bone fragment
• Make a small incision laterally through the skin and fascia
• Use a 3.2mm drill bit to prepare an entrance for the PIN insertion 
• Osteosynthesis by external fixation with 1 bar, 6 connectors and 6 pins 
• Washing with normal saline
• Skin suture closing with nylon 2.0
• (Wet) Dressing with sterile compressive. 

Post operation treatment: 

1. PIV NSS 0.9% 1000ml/24H
2. Ceftriaxone (1g): 1fl x 2 (IVL)
3. Gentamycin (80mg): 1A x 2 (IM) (FOR 5 Days)
4. Metronidazole (500mg): 1fl x 2 (PIV)
5. Paracetamol (1g): 1fl x 3 (PIV)
6. Tramadol (100mg): 1A x 2 (IM)
7. Cimetidine (200mg): 1A x 2 (IVL)