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Gustillo & Anderson Classification of Open Lower Limb Fractures

These diagrams and illustrations have been designed to help you learn, memorise and recall key information.

Grade followed by definition.


I = Open fracture, clean wound, wound <1 cm in length

II = Open fracture, wound > 1 cm but < 10 cm in length without extensive soft-tissue damage, flaps, avulsions

III = Open fracture with extensive soft-tissue laceration (>10 cm), damage, or loss or an open segmental fracture. This type also includes open fractures caused by farm injuries, fractures requiring vascular repair, or fractures that have been open for 8 hr prior to treatment

IIIA = Type III fracture with adequate periosteal coverage of the fracture bone despite the extensive soft-tissue laceration or damage


IIIB = Type III fracture with extensive soft-tissue loss and periosteal stripping and bone damage. Usually associated with massive contamination. Will often need further soft-tissue coverage procedure (i.e. free or rotational flap)


IIIC = Type III fracture associated with an arterial injury requiring repair, irrespective of degree of soft-tissue injury.

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