Gustilo-Anderson Classification of Open Fracures
Background
- Follow ALTS approach - beware of other injuries
- Analgesia
- Higher classification = more contamination, higher neurovascular risk
- Higher classification = ↑↑risk infection
- Repeated secondary assessment (NV status)
- Early antibiotics
- Remove gross contamination but do not irrigate (needs theatre)
- Betadine dressing and early immobilisation
Classification
Gustilo-Anderson classification
| Characteristic |
Type 1 |
Type 2 |
Type 3a |
Type 3b |
Type 3c |
| Wound size |
<1 cm |
>1 cm |
<10 cm |
>10 cm |
Any size |
| Contamination |
Clean |
Moderate |
|
|
|
| Soft tissue injury |
Minimal |
Minimal |
Crushed tissue |
Extensive |
Extensive |
| Fracture pattern |
Simple |
Moderate comminution |
Segmental with displacement |
| Diaphyseal segment loss |
| Gunshot wound |
| Soft tissue coverage |
Adequate |
Adequate |
Adequate |
Inadequate—plastic surgery needed |
Possible amputation needed |
| Vascular injury |
None |
None |
None |
None |
Present |
Links
Content by Dr Íomhar O' Sullivan 19/09/2014. Last review Dr ÍOS 24/10/22.
