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Open (Compound) fractures

Goals

  • Prevention of infection

  • Healing of the fracture

  • Restoration of function

 

Classification - Gustilo and Anderson

Type 1

 

Wound less than 1cm long

Moderately clean puncture, where spike of bone has pierced the skin

Little soft tissue damage

No crushing

Fracture usually simple transverse or oblique with little comminution

 

Type 11

 

Laceration more than 1cm long

No extensive soft tissue damage, flap or contusion

Slight to moderate crushing injury

Moderate comminution

Moderate contamination

Type 111

 

 

Extensive damage to soft tissues

High degree of contamination

Fracture caused by high velocity trauma

  111A

Includes any segmental or severely comminuted closed or open fractures, regardless of the size of the wound  

Soft tissue coverage of the bone is adequate.

  111B

Extensive injury to or loss of soft tissue, with periosteal stripping and exposure of bone,

Massive contamination

Severe comminution of fracture

After debridement a segment of bone is exposed and a local or free flap is required to cover it

 

111C

Any fracture with an arterial injury which


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