What is the proper treatment for fracture blisters?

• A. De-roof the blister
• B. Aspiration
• C. Suture closed
• D. Incision and drainage

Answer: (B)

Fracture blisters come from swelling and stress on the skin over a fractured area, signaling vulnerable soft tissue. The goal is to protect the skin and time definitive fixation so it can proceed without the skin breaking down or getting infected. Decompressing the blister with sterile needle aspiration reduces the intrablister pressure, lowers the risk of rupture, and preserves the skin’s barrier, which helps you plan for surgical fixation once the soft tissue envelope has settled.

Puncturing or removing the blister wall (de-roofing) or draining a blister by making incisions creates an open wound that exposes raw dermis, raises infection risk, and complicates healing or timing of fixation. Suturing the blister closed traps fluid and can worsen tissue viability under tension. So, aspiration to relieve pressure provides a temporary, skin-preserving measure that supports safer future surgery, whereas the other approaches compromise skin integrity or increase infection risk. After aspiration, protect the area with a nonadherent dressing and await resolution of the blister before definitive fixation.