An open long bone fracture is a serious injury not only because of the associated significant soft tissue collateral damage but because the exposed bone is contaminated and the risk of deep infection is greatly increased. Urgent assessment and appropriate management can mean the difference between successful limb salvage and reconstruction and not. Patients with open fractures should be treated in centres that can offer the full spectrum of ‘ortho-plastic’ services, including soft tissue and bone reconstruction. Such teams are found in major trauma centres and in some specialist ortho-plastic centres. These are the preferred primary destinations for such patients.
The British Orthopaedic Association (BOA) and British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) have worked together to produce professional guidelines for the management of severe open tibial fractures, promoting a joint ‘ortho-plastics’ approach to care, and this has led to the development of clinical audit standards that have been used both nationally and internationally to improve the care of trauma patients.
We present the evidence base and rational behind the UK BOA & BAPRAS open lower limb standards of care and explore their potential to be adopted and implemented in New Zealand. Is there the desire within NZAPS to create, endorse and promote New Zealand’s own standards of care for open lower limb trauma?