Manejo de fracturas tibiales, grado 3c, en el primer nivel de atención de salud

Abstract

INTRODUCTION: Open fractures, especially grade III C fractures of the tibia, represent a significant challenge in the field of traumatology due to their complexity and high rate of complications. These injuries result from high-energy trauma, such as traffic accidents, and are characterized by exposure of the bone to the external environment through a skin and soft tissue wound. Associated complications include infections, compartment syndrome, no bone junction, and, in severe cases, amputations. OBJECTIVE: To describe the management of tibial fractures, grade III C, in primary health care. METHODOLOGY: An exhaustive review of the available scientific literature on the management of exposed fractures of the tibia in databases such as Cocrhane, Scielo, Pubmed, from 2019 to 2024. DEVELOPMENT: Open fractures of the tibia, especially grade III C, require a multidisciplinary approach and multiple surgical interventions. The infection rate in these fractures varies significantly, between 3% and 40%, depending on factors such as the type of fracture, the degree of injury in soft tissues and the treatment strategies implemented. The modern management of these fractures focuses on three fundamental pillars: prevention of infections, early stabilization of fracture and adequate coverage of soft tissues. CONCLUSION: The complexity of grade 3C open tibial fractures requires multidisciplinary management that includes the administration of broad-spectrum antibiotics and timely referral to centers with greater resolution capacity.