What is the recommended initial treatment for open fractures?

The recommended initial treatment for open fractures emphasizes the urgent need to prevent infection, which is a significant risk associated with any open fracture due to exposure of the bone and soft tissue. Starting intravenous (IV) antibiotics within three hours is critical because it provides a strong defense against potential pathogens that may have entered the wound at the time of injury. Administering antibiotics quickly can significantly reduce the risk of complications such as osteomyelitis and help in the overall management of the injury.

Other treatment options, while relevant in the broader context of fracture management, do not address the immediate concerns associated with open fractures. For instance, immediate application of a plaster cast is not performed in open fractures due to the potential for exacerbating infection and complications related to compromised skin integrity. Referral for amputation is typically not a first-line treatment and is reserved for severe cases where limb salvage is not possible. While oral pain management is important for overall comfort, it does not address the immediate and critical concern of infection prevention in open fractures. Therefore, starting IV antibiotics promptly is the most appropriate choice in the context of initial management for an open fracture.