Top 5 Tips for Compound Fractures

It’s World Trauma Day. Dr. David Wellman, Orthopedic Surgeon, explains what a compound fracture is and what you should do to treat this serious injury. “A ‘compound’ or ‘open’ fracture refers to a break in the bone with a laceration in the overlying skin, leaving the fracture fragments open to the outside environment. This is a very serious injury with potential long term consequences if not treated appropriately,” says Dr. Wellman.

In the unfortunate event of a compound fracture, patients should remember the following tips:

1. A compound fracture is a true emergency, and appropriate care should be sought immediately. Usually, this involves calling the local emergency ambulance service to ensure that the patient is transferred safely to a hospital with an on-call orthopedic surgery team. In most situations, the patient will require an emergency surgical procedure to clean the wound and treat the fracture.

2. While waiting for care to arrive, the patient should not move around unnecessarily, because the fracture is open to the outside environment and could become infected. One of the major consequences of a compound fracture is an infection at the fracture site, which should be avoided at all costs.

3. One should not try to re-align the extremity where the bone is broken without the presence of trained medical personnel who have the proper splinting supplies. Improper handling could cause contamination of the wound and damage to the traumatized tissues.

4. Try to keep the extremity as clean as possible. Place moist sterile gauze over the wound if available. At a minimum, the wound should be protected from contact with the ground or unclean surfaces.

5. Pay attention to signs of compartment syndrome. This is a serious complication of extremity trauma that develops over time; it is caused when swelling increases pressure at the site of the injury. If the pressure from the swelling becomes greater than the incoming blood pressure, the extremity receives no blood. Immediate surgical intervention to release the pressure is required if this situation arises. In addition to swelling, warning signs include increasing pain, numbness, weakness, decreasing pulse, and a color change in the extremity. If not treated properly, compartment syndrome can lead to permanent muscle and nerve damage.

Dr. David S. Wellman is an orthopedic surgeon specializing in the care of fractures and post-traumatic reconstruction. He has particular interests in articular fractures (bone breaks near major joints), injuries to the pelvis and acetabulum, and fracture non-union and mal-union. These interests also motivate his research work outside the operating room.

The information provided in this blog by HSS and our affiliated physicians is for general informational and educational purposes, and should not be considered medical advice for any individual problem you may have. This information is not a substitute for the professional judgment of a qualified health care provider who is familiar with the unique facts about your condition and medical history. You should always consult your health care provider prior to starting any new treatment, or terminating or changing any ongoing treatment. Every post on this blog is the opinion of the author and may not reflect the official position of HSS. Please contact us if we can be helpful in answering any questions or to arrange for a visit or consult.


  1. Hello Doctor,
    I broke 3 ribs on my right side on 6/18. The problem (i think) is that they are not healing properly. One still “clicks” when I sneeze, and there seems to be a large gap between the other two. I saw an orthopedic surgeon in mid-August, and said if they don’t heal in a month to find a cardiac/thoracic surgeon. Please don’t be insulted, but he said to never let an orthopedic surgeon operate on your chest, that a cardiac/thoracic surgeon is more familiar with this area of your body. Do you agree with this, and have any advice for me? Anything would be appreciated.
    Thank you for your time, Maryann

    1. Hi Maryann- While orthopedic surgeons are not familiar with the chest, thoracic surgeons are typically not familiar with nonunions. It’s probably best to do the case with both surgeons involved.

  2. I have a compound fracture on my left forearm /wrist. though it’s only A week old I allowed it out of my cast. So far I’ve been fine so long as I’m very delicate and only try moving parts of my wrist one at a time and VERY slowly. Tomorrow is when a dr is supposed to look at it and tell me if the castcAn come off but since I beat them to it, should I continue to leave the cast off and see what happens or am I simply risking a much worse scenario for the sake of 24 extra hours free of my cast?

    1. Hi Jeffrey, thank you for reaching out! Dr. David Wellman, Orthopedic Trauma Surgeon, has responded to your question, he says:”Under no circumstance should you remove a cast against a doctors order. You risk losing alignment and making the situation worse. In certain circumstances, surgery is necessary to correct the lost alignment.” It would be best for you to consult with your treating physician so they can determine the best course of treatment.

  3. I had a compound fracture 55 weeks ago,and still not completely healed.I developed a infection at the beginning of the year which slowed my healing.What suggestions can you suggest.

    1. Hi Jack, thank you for reaching out. It is best for you to consult in-person with a physician so they can better advise. If you wish to receive care at HSS, please contact our Physician Referral Service at 877-606-1555 for further assistance.

  4. I have an 81 yr. old friend, with osteoporosis, she had a hip replacement, ws doing very well, until she fell, was looked at in hospital and told she had a compound fracture, somewhere in her spinal region, although I haven’t seen her, she was Sent home with pain meds. and nothing else, I’d lilke to get info on this. Wouldn’t some kind of surgery be needed ?

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