Gustilo-Anderson Classification System
- This is a grading system for the identification of open fractures and its severity.
- Fractures are designated as one of these three types and subtypes based on:
|Gustilo-Anderson Classification System|
|Type I Fracture||Open fracture with clean wound <1cm long|
|Type II Fracture||Open fracture with laceration >1cm long without extensive soft tissue damage|
|Type III Fracture||Open segmental fracture, open fracture with extensive soft tissue damage, or traumatic amputation|
|Type IIIA Fracture||Adequate soft tissue coverage of a fractured bone despite extensive soft tissue laceration or flaps, or high energy trauma irrespective of the size of the wound|
|Type IIIB Fracture||Extensive soft tissue injury loss with periosteal stripping and bone exposure, usually associated with massive contamination|
|Type IIIC Fracture||Open fracture associated with arterial injury repair|
Reliability of the classification and a collective understanding and agreement of observers remains an issue. With Gustilo-Anderson Classification, here are its limitations:
1.Does not take tissue viability or tissue necrosis into account.
2.Moderate to poor inter-observer reliability.
3.Wound size and outward appearance may not accurately identify the true extent of the injury.
- a.Under-classifications has occurred on several accounts in the Emergency Department admission.
- b.Classification can only be made most precisely by surgeon in the OR following wound exploration and debridement.