In a compound fracture, which may also be called an open fracture, the broken bone breaks through the skin. It may be completely visible or the perforator bone may have been removed, leaving an open wound to the bone. These fractures tend to be very risky for a number of reasons and generally need fairly immediate surgical treatment for best healing.
The most compelling reason to get medical help for a person with a compound fracture is to avoid infection. Any break in the skin leaves the injured area vulnerable and it is possible for bacteria to enter the wound. Depending on the type of fracture, it may even be possible for bacterial infection to affect the bone, which can create a significant challenge for healing. To prevent this, doctors usually want to repair the bone and close the wound as quickly as possible, while perhaps giving you antibiotics to make sure no infection develops. Delaying this increases the risk of infection and can turn the repair from a simple process to a complex one.
The only thing you should do while taking a person to the doctor or waiting for emergency assistance is to cover any wounds with sterile gauze. If a protruding bone can be avoided and bleeding is profuse, light pressure may be applied to sterile dressings. This is not always possible because a significant bony protrusion would mean putting pressure on the fracture area, potentially damaging it further. For the most part, people should keep the injured person as still as possible. Applying a tourniquet to stop bleeding is not recommended if emergency help is nearby.
Compound fracture repair usually involves surgery. The type of surgery and the extent of the repair depend on the total extent of the injury. The duration of healing depends on the severity of the injury, but is usually at least two months or more. Surgeons may need to place screws or plates to stabilize a bone, which may require later surgery to remove it.
The severity of the open fracture does not mean that simple fractures, where the skin is not punctured, are not complex either. At least with a compound fracture, it's easy to guess that the injury needs treatment right away. With simple fractures, the bones can still move and disrupt internal tissue and things like ligaments can be severed. This suggests that people shouldn't delay getting treatment for closed fractures, either.