Nineteen patients underwent early open reduction and internal fixation in the presence of intact fracture blisters. In 17 cases the incision healed within 3 days, sealing off the deeper structures, and reepithelialization of the blister bed then occurred at a later date. Two of the patients who had incisions pass through blood-filled blisters developed wound healing complications. Although there was no significant difference in the outcome of the soft-tissue treatment techniques, our present practice is to leave all fracture blisters intact. If the blisters rupture spontaneously, they are deroofed and covered with a nonadherent dressing.
Early surgery is contemplated in patients with intact blisters and without severe swelling.