fractures and Injuries
Several factors can influence the severity of an open fracture. For example, the bones can be broken cross-wise, length-wise, and in several pieces. The pieces of bone can be very sharp and can tear through soft tissue from within.
A direct blow may tear and crush skin and soft tissues, as well as bone. If the bone shatters, there can be a multitude of fragments which may penetrate the neurovascular tissues and surrounding soft tissues.