Which factor would contraindicate the use of external coaptation for fracture stabilization?

• A. Simple fracture with minimal soft tissue injury
• B. Fracture location on a non-weight-bearing bone
• C. Poor owner compliance
• D. Extensive soft tissue injury and high infection risk

Answer: (D)

External coaptation works best when the soft tissue around the fracture is healthy, because immobilization should not compromise blood flow, wound evaluation, or healing. If there is extensive soft tissue injury and a high infection risk, immobilizing the area with a cast or splint can trap bacteria, moisture, and debris against damaged tissue, hinder wound care, and put pressure on compromised skin or tissue. This increases the chance of infection and tissue necrosis and makes healing less likely, so external coaptation is contraindicated in that scenario. The other situations are more compatible with this method: a simple fracture with minimal soft tissue injury can be immobilized safely; a fracture on a non-weight-bearing bone can still be stabilized externally; and while poor owner compliance is a practical challenge, it isn’t an absolute medical contraindication by itself.