Difference between an Open and a Closed Fracture

By: | Updated: May-28, 2019

Both open and closed fractures require immediate medical attention. Since they greatly differ in a number of ways, learning to distinguish between the two is critical in developing an appropriate health care plan.

Summary Table

Open FractureClosed Fracture
Also called a compound fractureAlso called a simple fracture
Manifested by a break in the skinManifested by skin swelling, bruising, and a bone deformity
Puts the patient at risk for infectionDoes not put the patient at risk for infection
Treatment options include debridement and irrigation, antibiotic prescriptions, skin grafts, free flap, local flap, internal fixation, and external fixationTreatment options include cast immobilization, internal fixation, and external fixation
Longer healing timeShorter healing time

Definitions

open and a closed fractures
Images of open and a closed fractures

An open fracture, commonly referred to as a compound fracture, is a type of fracture characterized by an open wound on the skin that overlays a broken bone.

Meanwhile, a closed fracture, also known as a simple fracture, is a type of fracture where the broken bone does not protrude out of the skin.

Open vs Closed Fracture

Both may be characterized by a break in the bone, but there is still a huge difference between an open and a closed fracture.

Terminology

An open fracture is known as a compound fracture, while a closed fractured is commonly called a simple fracture.

Clinical Manifestations

An open fracture involves a break in the skin, which is caused by the protrusion of a broken bone. In severe cases, the internal tissues and the bone can also be exposed, depending on the impact of the incident that caused the injury.

A closed fracture, by contrast, does not cause any skin breakage. However, visible signs like skin swelling, bruising and a bone deformity are typically present near the fractured bone.

Risk for Infection

Unlike a closed fracture, an open fracture puts the patient at risk for infection because of the presence of an open wound, which can be a pathway for dirt, bacteria, and other contaminants.

Treatment

Both open and closed fractures may require internal fixation or external fixation. Internal fixation realigns the bones by the use of metal implants, while external fixation immobilizes and heals the bones with the help of metal pins and screws. Despite their similarity, there are still significant differences in how the two are treated, depending on the severity of the injury.

The primary goal behind the treatment of an open fracture is to prevent infection and to realign the bones. Infection control involves debridement and irrigation, which is performed to remove all possible contaminants that entered the open wound. The health care plan for an open fracture also includes the use of antibiotics. More complex types of open fractures that are characterized by severe tissue and skin loss may also require skin and tissue transplants such as skin grafts, free flap, and local flap.

A closed fracture, by comparison, does not require any of these measures. While internal fixation or external fixation is a critical treatment plan for severe closed fractures, simpler cases can be treated by cast immobilization, which promotes bone healing and realignment.

Recovery

The recovery period of open closed fractures greatly depends on the severity of the fracture. However, between the two, an open fracture is slower to heal since it involves the tissue and the skin. Typically, a closed fracture can be treated in four weeks or more, while an open fracture takes months to recover.

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