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Gustilo Open Fracture Classification Calculator

  • Wound size in centimeters
  • Contamination level
  • Is bone exposed
  • Soft tissue loss present
  • Periosteal stripping or bone devascularization
  • Vascular injury requiring repair
  • Mechanism energy level
  • Gustilo Open Fracture Classification Explanation and Clinical Context
    The Gustilo open fracture classification system categorizes open fractures by wound size soft tissue injury contamination and associated vascular injury. Type I indicates a clean wound less than or equal to 1 centimeter with minimal soft tissue damage. Type II indicates a wound greater than 1 centimeter and less than or equal to 10 centimeters without extensive soft tissue loss or periosteal stripping. Type III refers to high energy injuries or wounds larger than 10 centimeters or those with extensive soft tissue damage. Type IIIA describes extensive laceration or flaps with adequate soft tissue coverage of bone. Type IIIB indicates extensive soft tissue loss with periosteal stripping and bone exposure frequently requiring flap coverage. Type IIIC denotes any open fracture associated with arterial injury that requires repair and carries increased risk for limb loss. Clinical management decisions should integrate mechanism patient comorbidity contamination and vascular status and often require timely debridement stabilization antibiotics and vascular or soft tissue reconstruction when indicated.

    Reference
    Gustilo RB and Anderson JT. Prevention of infection in the treatment of one thousand and twenty five open fractures of long bones prospective and retrospective analyses. Journal of Bone and Joint Surgery American volume 1976 58 453 458
    Gustilo RB Mendoza RM Williams DN. Problems in the management of type III open fractures a new classification of type III open fractures. Journal of Trauma 1984 24 742 746

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