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First aid should be directed immediately toward reduction of the fracture by traction, protection of the wound with sterile gauze and splinting with plaster, steel or wooden splints.
On the patient's admission to the hospital, anteroposterior and lateral roentgenograms are made.
Sterile gauze is placed in the wound; the surrounding skin is shaved and thoroughly cleansed with soap, water, ether or benzine. The gauze is then removed from the wound, and an adequate débridement of the devitalized skin, fascia, muscle and detached bone is made. The débridement is of the greatest importance and should be done thoroughly. Wounds compounded from within are usually not as severe as those received from without, nor is the contamination as great. The fracture is then reduced and immobilized by splinting, and the Carrel method of treatment of the wound is instituted at once.
REDUCTION OF FRACTURE
Manipulation and manual traction should be attempted
SHERMAN WO. TREATMENT OF COMPOUND FRACTURES. Arch Surg. 1940;40(5):838-843. doi:10.1001/archsurg.1940.04080040020003