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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No vascular injury is identified. The Gustilo-Anderson classification is widely used [ 6 ], and is the basic language with which many investigators communicate the results of open fracture treatment [ 5 ]. Therefore, assessment of all open fractures should include the mechanism of injury, the appearance of soft tissues, the likely levels of bacterial contamination and the specific characteristics of the fractures. Goals of fracture treatment should be to prevent infection, promote fracture healing, and restore function.

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The kappa value [ 920 ] in this study was 0. Interobserver reliability in the Gustilo and Anderson classification of open fractures. After reviewing their initial classification of the most severe open injuries, Gustilo et al.

Gustilo Classification – Trauma – Orthobullets

Infection The grade of open fracture, condition of the soft tissues, degree of contamination and the thoroughness of surgical debridement will have influence on the risk of infection. Cochrane Database Syst Rev.


Delayed primary closure historically has been used, especially for Type III fractures, but consideration for earlier closure has been reported. By using this site, you agree to the Terms of Use and Privacy Policy. Associated arterial injury must be identified and treated urgently to salvage the limb.

Open Fracture: Gustilo classification

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 injuries. Retrieved from ” https: The variability among individuals and their interpretation of the Gustilo-Anderson classification [ 16 ] results in a spectrum of injuries having too much overlap [ 5 ], possibly owing to the observer error [ 19 ].

Retrospective and prospective analyses. To comprehensively measure prognosis, outcome measures such as the Sickness Impact Profile [ 2 ] can be used claswification more accuracy.

Open Fractures

Newer evidence shows that stabilization of many of these fractures—even with internal fixation—reduces the risk of infection and malunion, promotes fracture healing, restores function, and expedites rehabilitation [ 4 ]. These grading systems seek to help guide treatment, improve communication and research, and predict outcome. Thorough evaluation of the entire patient is essential before focusing on the injured leg. Management of open fractures and subsequent complications. Any evidence of contamination should be assessed for and documented — marine, agricultural, and sewage contamination is of the highest importance.


Factors influencing infection rate in open fracture wounds. Thank you for updating your details. 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.

This article has been corrected. J Am Acad Orthop Surg. A plain film radiograph of the affected area s will be required Fig.

Wound debridement will be necessary. Elevated compartment tissue pressure is not prevented by an open fracture wound.

Gustilo open fracture classification – Wikipedia

Gustilo-Anderson classification grade 1: Another critical limitation is that the surface injury does not always reflect the amount of deeper tissue damage and the Gustilo-Anderson classification does not account for tissue viability and tissue necrosis, which tend to evolve with time after more severe injuries.

Edit article Share article View revision history. These slides subsequently were evaluated by 22 orthopaedic surgeons eight attending orthopaedic surgeons and 14 orthopaedic residents. Finally, Bowen and Widmaier found that the number of compromising comorbidities to be significant independent predictors of infection [ 4 ].