Gustilo and Anderson Open Fracture Classification
Habib Olapade
UK pre law student; Falsely imprisoned in TX intending to move to CA, HI, or UK upon release.
The Gustilo and Anderson open fracture classification uses three grades and divides the third most severe grade into three subtypes. First, Grade I fractures result from a low energy injury with a wound less than 1 cm in length often from an inside out injury rather than an outside in injury. Grade I fractures are generally simple transverse or short oblique fractures. Second, Grade II fractures involve a wound more than 1 cm long. These injuries usually display some comminution and have a minimal to moderate crushing component. Third, Grade III open fractures include extensive wounds more than 10 cm in length, significant fragment comminution and a great deal of soft tissue damage. These injuries usually result from high velocity gunshots, motorcycle accidents, or injuries with contamination from outdoor sites. Not all Grade III injuries, though, are created equal. Grade IIIA fractures have extensive soft tissue laceration with minimal periosteal stripping and have adequate bone coverage. By way of contrast, Grade IIIB fractures have extensive soft tissue injury with periosteal stripping and require a flap for coverage. Finally, Grade IIIC injuries involve a vascular compromise requiring surgical repair or reconstruction to allow for limb reperfusion.