World Library  
Flag as Inappropriate
Email this Article

Gustilo open fracture classification

Article Id: WHEBN0026895032
Reproduction Date:

Title: Gustilo open fracture classification  
Author: World Heritage Encyclopedia
Language: English
Subject: ICD-10 Clinical Modification, Danis–Weber classification, Lister's tubercle, Medical education in the Philippines, Thomas test
Collection: Bone Fractures, Orthopedic Classifications
Publisher: World Heritage Encyclopedia
Publication
Date:
 

Gustilo open fracture classification

The Gustilo open fracture classification system is the most commonly used classification system for Open fractures. It was created by Ramon Gustilo and Anderson, and then further expanded by Gustilo, Mendoza, and Williams.[1][2][3]

This system uses the amount of energy, the extent of soft-tissue injury and the extent of contamination for determination of fracture severity. Progression from grade 1 to 3C implies a higher degree of energy involved in the injury, higher soft tissue and bone damage and higher potential for complications. Important to recognize that grade 3C fracture implies vascular injury as well. [4]

Classification

Gustilo open fracture Classification
Gustilo Grade Definition
I Open fracture, clean wound, wound <1 cm in length
II Open fracture, wound > 1 cm but < 10 cm in length[4] without extensive soft-tissue damage, flaps, avulsions
III Open fracture with extensive soft-tissue laceration (>10 cm[4]), damage, or loss or an open segmental fracture. This type also includes open fractures caused by farm injuries, fractures requiring vascular repair, or fractures that have been open for 8 hr prior to treatment
IIIA Type III fracture with adequate periosteal coverage of the fracture bone despite the extensive soft-tissue laceration or damage
IIIB Type III fracture with extensive soft-tissue loss and periosteal stripping and bone damage. Usually associated with massive contamination. Will often need further soft-tissue coverage procedure (i.e. free or rotational flap)
IIIC Type III fracture associated with an arterial injury requiring repair, irrespective of degree of soft-tissue injury.

Reliability

There are many discussions regarding the inter-observer reliability of this classification system. Different studies show inter-observer reliability of approximately 60% (ranging from 42 to 92%).[5][6]

Another important issue of this classification system is the ability to predict outcome. For this purpose, other classification systems, like Mangled Extremity Severity Score (MESS) and Limb Salvage Index (LSI) have been devised.[7][8]

Gustilo type I open fracture
Gustilo type II open fracture

References

  1. ^ Rüedi, etc. all; Thomas P. Rüedi; Richard E. Buckley; Christopher G. Moran (2007). AO principles of fracture management, Volume 1. Thieme. p. Page 96.  
  2. ^ 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;58:453–8
  3. ^ Gustilo RB, Mendoza RM, Williams DN. Problems in the management of type III (severe) open fractures: A new classification of type III open fractures. J Trauma. 1984;24:742–6.
  4. ^ a b c http://www.orthobullets.com/trauma/1003/gustilo-classification
  5. ^ Brumback RJ, Jones AL. Interobserver agreement in the classification of open fractures of the tibia: The results of a survey of two hundred and forty-five orthopaedic surgeons. J Bone Joint Surg Am. 1994;76:1162–6
  6. ^ Cross WW, Swiontkowski M. Treatment principles in the management of open fractures.Indian J Orthop. 2008 Oct-Dec; 42(4): 377–386.
  7. ^ Johansen K, Daines M, Howey T, Helfet D, Hansen ST., Jr Objective criteria accurately predict amputation following lower extremity trauma. J Trauma. 1990;30:568–72
  8. ^ MacKenzie EJ, Bosse MJ, Kellam JF, Burgess AR, Webb LX, Swiontkowski MF, et al., editors. Factors influencing the decision to amputate or reconstruct after high-energy lower extremity trauma. J Trauma. 2002;52:641–9
This article was sourced from Creative Commons Attribution-ShareAlike License; additional terms may apply. World Heritage Encyclopedia content is assembled from numerous content providers, Open Access Publishing, and in compliance with The Fair Access to Science and Technology Research Act (FASTR), Wikimedia Foundation, Inc., Public Library of Science, The Encyclopedia of Life, Open Book Publishers (OBP), PubMed, U.S. National Library of Medicine, National Center for Biotechnology Information, U.S. National Library of Medicine, National Institutes of Health (NIH), U.S. Department of Health & Human Services, and USA.gov, which sources content from all federal, state, local, tribal, and territorial government publication portals (.gov, .mil, .edu). Funding for USA.gov and content contributors is made possible from the U.S. Congress, E-Government Act of 2002.
 
Crowd sourced content that is contributed to World Heritage Encyclopedia is peer reviewed and edited by our editorial staff to ensure quality scholarly research articles.
 
By using this site, you agree to the Terms of Use and Privacy Policy. World Heritage Encyclopedia™ is a registered trademark of the World Public Library Association, a non-profit organization.
 


Copyright © World Library Foundation. All rights reserved. eBooks from Project Gutenberg are sponsored by the World Library Foundation,
a 501c(4) Member's Support Non-Profit Organization, and is NOT affiliated with any governmental agency or department.