Q-2 · Open Fractures · trauma · A–E keys

After debridement of a high-energy open tibia, bone is exposed and the remaining envelope will not close without tension. Vascular exam is intact. Which statement should drive tonight’s plan?

• A.A perfect articular reduction under a compromised flap is still a win if the hardware is anatomic
• B.Grade the injury only from the arrival photo — grading never changes after debridement
• C.Fixation choice follows the realistic envelope; call coverage early if a flap will be required
• D.Primary closure under tension is preferred to leaving the wound open