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Gustilo and Anderson open fracture Classification

Open fractures +

I -- Wound < 1 cm with no extensive damage / contamination.

II -- Wound >1cm but <10cm with no extensive damage / contamination.

III -- Open fracture with extensive soft-tissue laceration, damage, or loss or an open segmental fracture.

      3 a. Soft tissue contamination but periosteum spared/intact
      3 b. Periosteum broken and bone is bare.
      3 c. associated with NeuroVascular damage.


All open fractures are Surgical emergencies.

T/t -- Damage control orthopedics

  1. Thorough debridement
  2. Fracture stabilization by external fixation
  3. Delayed closure of wound.

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