The Gustilo open fracture classification system is the most commonly used classification system for open fractures. It was created by Ramón Gustilo and Anderson, and then further expanded. Open Fracture: Gustilo classification. Open fractures have been classified by Gustilo as follows, with higher numbers indicating more severe injuries. Open fractures, also called compound fractures, are severe injuries to bones. These injuries almost always require surgery. Learn more.

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Gustilo open fracture classification

Ultimately, through their studies of prevention of infection in open long bone fractures [ 1617 ], Gustilo et al. Many of the principles outlined by Gustilo et al.

The epidemiology of open long-bone fractures. National Center for Biotechnology InformationU.

A plain film radiograph of the affected area s will be required Fig. Usually associated with massive contamination. Simple fx pattern with minimal comminution.

History Open fractures usually are high-energy injuries. Any evidence of contamination should be assessed for classificatoin documented — marine, agricultural, and sewage contamination is of the highest importance.

Open Fracture: Gustilo classification

Synonyms or Alternate Spellings: A coefficient of agreement for nominal scales. The kappa value [ 920 ] in this study was 0. Local or free-tissue transfers may be required, if tension-free closure is not possible. The AO classification of fracture wound severity provides a grading system for injuries of each of the skin Imuscles and tendons MTand neurovascular NVeach of which is divided into five degrees of severity.

Compression-plate fixation of acute fractures of the diaphyses of the radius and ulna. Whilst most of these injuries can be safely managed on next day emergency lists, there are instances where emergency out-of-hours treatment is required.


Thank you for rating! The Gustilo Anderson classificationalso known as the Gustilo classificationis the most widely accepted classification system of open or compound fractures. Wound debridement will be necessary. HPI – The patient reported an injury of the right forefoot her foot caught in the wheel of the quadbike and she presented 10 hours after the incident.

Patients will present with pain, swelling, and deformity, with an overlying wound or punctum in severe cases, the bone end may be visible protruding from the wound.

Clin Orthop Relat Res. How important is this topic for clinical practice?

They categorized open injuries into the classirication three categories, based on wound size, level of contamination, and osseous injury, as follows: Type III fractures, however, are not a homogeneous group; another study found a considerable range of infection rates among the subtypes of Type III injuries, with 1. Gustilo and Anderson [ 16 ] emphasized the importance of debridement but Pollak et al. It is designed to provide a unique, unequivocal definition of any injury and thereby, allows accurate comparison of cases.

This information is intended for medical education, and does not create any doctor-patient relationship, and should not be used as a substitute for professional diagnosis and treatment. Left untreated, open fractures are associated with high rates of morbidity and mortality. Log in Sign up. Requires free tissue flap or rotational flap coverage.

Despite the overall improvement in outcome after open fractures, the variable outcomes among different patterns of open fractures with differing severities prompted the development of grading systems that classify them based on increasing severity of the associated soft tissue gusitlo. The original study [ 16 ] included an initial retrospective evaluation, followed by a prospective test of the system that Gustilo and Anderson ahderson.


Support Center Support Center. L6 – years in practice. Classiication system uses the amount of energy, the extent of soft-tissue injury and the extent of contamination for determination of fracture severity. How important is this topic for board examinations?

Retrieved from ” https: The results of a survey of two hundred and forty-five orthopaedic surgeons. Impaired bone healing Delay or failure of bone healing is common with open tibial fractures. The need for plastic surgery input should be identified early, to allow both specialties to be present at the first operation and therefore avoid multiple procedures.

Like many classification clzssification, the purpose of the Gustilo-Anderson schema is to provide a prognostic gusgilo that guides treatment and facilitates communication among surgeons and clinician-scientists. Problems in the management of type III severe open fractures: Broad-spectrum antibiotic cover should be administered, as per local guidelines, and a tetanus vaccination is required if the patient is not fully up-to-date with their vaccination.

Recombinant human bone morphogenetic protein-2 for treatment of open tibial fractures: This, along with the exposure of bone and deep tissue to the environment, leads to increased risk of infection, wound classifiation, and nonunion [ 122831 ]. However newer studies have shown that early wound closure and early fixation reduces infection rates, promotes fracture healing and early restoration of function.