Classification of Open Fractures

Open fracture is the fracture in which there is an associated wound over or near fracture site and that commmunicates with fracture hematoma.
Classification of open fractuers put them into increasing grades of severity. Open fractuers in general take longer time to unite than closed fractures

There are many classifications of open fractures but most followed has been that of Gustilo. It was later modified by Anderson ans the classification now used is thus Gustilo Anderson.

This classification is as follows

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. It is often accompanied by a high velocity injury or a severe crushing component.
Special patterns classified as Type III:

• Open segmental fracture, irrespective of the size of the wound
• Gunshot wounds -high velocity and short-range shotgun injuries
• Open fracture with neurovascular injury
• Farm injuries, with soil contamination, irrespective of the size of the wound.
• Traumatic amputations
• Open fractures over 8 hours old
• Mass casualties, e.g. war and tornado victims

Subtype IIIA

Adequate soft tissue coverage despite soft tissue laceration or flaps or high energy trauma irrespective of the size of the wound. This includes segmental fractures or severely conminuted fractures.

Subtype IIIB

Extensive soft tissue lost with periosteal stripping and bony exposure. This is usually associated with massive contamination.

Subtype IIIC
Fracture in which there is a major arterial injury requiring repair for limb salvage

A fracture classification helps to plan the treatment and indicates the severity of injury without much description

Popularity: 3% [?]