Gustilo Anderson classification, Gustilo open fracture classification

Gustilo classification

Open fracture classification system is given by Gustilo and Anderson, this classification also known as “The Gustilo open fracture classification”, it is most widely use classification system for open (or compound) fractures.

This grading system is depend up on amount of energy dissipated, extent of soft-tissue injury, and degree of contamination for determination of fracture severity

  Grade 1:

  • <1cm breach in skin
  • clean wound bed
  • no soft tissue involvement
  • fracture with Normal Neurovascular Injury

Grade 2:

  • between >1 and <10 cm in length breach in skin
  • wound bed is moderatedly contaminated
  • no soft tissue involvement
  • fracture with Normal Neurovascular injury

Grade 3:

  • >10cm breach in skin
  • segmental fracture with displacement
  • extensive soft tissue involvement
  • fracture with Normal neurovascular injury
  • Traumatic amputations
  • caused by crushing force from fast moving vehicle
  • fracture should be 8 hours old for treatment

Grade 3a:

  • Grade 3 with adequate soft tissue involvement
  • Severe comminution or segmental fractures
  • No periosteal breach

Grade 3b :

  • Grade3+grade3a with for periosteal breach
  • More often need further soft-tissue coverage procedure

Grade 3c :

  • grade3+grade3a+grade3b with major vascular injury
  • Typically requires flap coverage
  • Require immediate action

Author: Dr. vivek saini


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