Gustilo-Anderson
Open Fracture Classification System
Select the classification that best describes the open fracture:
Type I
Clean wound, wound length <1 cm, minimal soft tissue damage, simple fracture pattern
Low-energy injury
Minimal contamination
Puncture wound from inside-out
I
Type II
Wound length >1 cm, moderate soft tissue damage, minimal periosteal stripping
Moderate-energy injury
No extensive soft tissue crushing
Adequate soft tissue coverage
II
Type IIIA
Extensive soft tissue damage, but adequate soft tissue coverage of bone despite laceration or flaps
High-energy injury
Segmental/comminuted fracture
No flap needed for coverage
IIIA
Type IIIB
Extensive soft tissue loss with periosteal stripping and bone exposure, massive contamination
High-energy injury
Requires flap coverage
Significant bone exposure
IIIB
Type IIIC
Open fracture with arterial injury requiring repair, regardless of degree of soft tissue injury
Vascular injury present
Limb-threatening
Requires immediate vascular repair
IIIC
Classify Injury
Type I
Low Energy Injury
Gustilo-Anderson Classification
Management Priorities
Antibiotic Protocol
Expected Complications
Low infection risk
New Classification
Reference
Gustilo RB, Anderson JT. Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: retrospective and prospective analyses. J Bone Joint Surg Am. 1976;58(4):453-458.