Which fracture has exposed tissue and high infection risk?

• A. CSF leak
• B. Skull fracture with exposed tissue, high infection risk
• C. PERRL
• D. Central support structure of vertebrae

Answer: (B)

Exposed tissue on a fracture signals an open (compound) fracture, where the break communicates with the outside environment. That breach of the skin barrier greatly increases infection risk because bacteria can directly enter the wound and reach bone—and in the skull, potentially reach intracranial structures. This makes a skull fracture with exposed tissue the scenario with the highest infection risk among the options.

The other choices don’t describe a fracture. A CSF leak is a symptom indicating possible intracranial involvement, not a fracture type. PERRL is a neuro exam finding (pupil response). Central support structure of the vertebrae refers to anatomy, not a fracture.