Trauma / Orthopaedics

Gustilo-Anderson Open Fracture Classification

Classify open fractures by wound size, soft tissue damage, and contamination. Guides antibiotic choice, surgical timing, and definitive management.

Guided Classification

1

Is there an associated vascular injury requiring repair?

Absent distal pulses, expanding haematoma, active arterial bleeding, or ABI < 0.9

VascularWound SizeCoverageResult

Quick Comparison

Type I
Wound: Less than 1 cm
Infection: 0–2%
Contamination: Clean wound

Small, clean wound with simple fracture

Type II
Wound: 1–10 cm
Infection: 2–10%
Contamination: Moderate

Larger wound with moderate soft tissue damage

Type IIIA
Wound: Usually greater than 10 cm
Infection: 10–25%
Contamination: High (including farmyard, segmental fractures, gunshot wounds)

High energy, extensive damage but bone is covered

Type IIIB
Wound: Usually greater than 10 cm
Infection: 25–50%
Contamination: Massive

Bone exposed, needs flap coverage

Type IIIC
Wound: Any size
Infection: 25–50%
Contamination: Variable

Any open fracture with vascular injury requiring repair. Limb-threatening.

Dr Sumit's Clinical Pearls

Based on Gustilo RB & Anderson JT. JBJS 1976. Enhanced with clinical pearls by Dr Sumit Mandal.