Kalpana Kalpana (Editor)

Gustilo open fracture classification

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Gustilo open fracture classification

The Gustilo open fracture classification system is the most commonly used classification system for open fractures. It was created by Ramón Gustilo and Anderson, and then further expanded by Gustilo, Mendoza, and Williams.

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.

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%).

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.

References

Gustilo open fracture classification Wikipedia