Revised Gustilo and Anderson’s Classification of Open Fractures

Classification

Type I:

  • Wound less than 1 cm with minimal soft tissue injury
  • Wound bed is clean
  • Fracture is usually a simple transverse, short oblique fracture, with minimal comminution

 

Type II:

  • Wound is greater than 1 cm with moderate soft tissue injury
  • Fracture is usually a simple transverse, short oblique fracture, with minimal comminution

 

Type III:

  • Fractures that involve extensive damage to the soft tissues, including muscle, skin and neurovascular structures
  • Often accompanied by a high-velocity injury or a severe crushing component
  • Special patterns classified as Type III:
    1. Open segmental fracture, irrespective of the size of the wound
    2. Gunshot wounds -high velocity and short-range shotgun injuries
    3. Open fracture with neurovascular injury
    4. Farm injuries, with soil contamination, irrespective of the size of the wound
    5. Traumatic amputations
    6. Open fractures over 8 hours old
    7. Mass casualties; eg, war and tornado victims

 

  • Subtype IIIA
    1. Adequate soft tissue coverage despite soft tissue laceration or flaps or high energy trauma irrespective of the size of the wound
    2. Includes segmental or severely conminuted fractures

 

  • Subtype IIIB  Subtype IIIC
    1. Extensive soft tissue lost with periosteal stripping and bony exposure
    2. Usually associated with massive contamination
    3. Fracture in which there is a major arterial injury requiring repair for limb salvage

Courtesy : http://www.iorg.co.in/2013/05/gustilo-anderson-classification-revisited-an-overview/

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