Klassifikation offener Frakturen nach Gustilo et al.

Anwendung

Frakturen

Type IA puncture wound type with a diameter of 1 cm or less and which is relatively clean. Most likely the spike of the bone pierces the skin from the inside without much muscle contusion or other soft tissue involvement and no crushing component. The fracture is usually a simple transverse, short and oblique with minimal comminution. 
Type IIAn open fracture with a laceration type more than 1 cm long without extensive soft-tissue damage, flaps, or avulsions and minimal to moderate crushing component. The fracture is usually a simple transverse, short and oblique with minimal comminution. 
Type IIIAn open fracture with extensive soft-tissue damage including muscle, skin, and neurovascular structures. It is often accompanied by a high-velocity -type injury or severe crushing component. Special problems include
- open segmental fractures, irrespective of the size of the wound, usually caused by
vehicular accident indicating high-velocity-type injury
- farm injuries with soil contamination irrespective of the size of the wound
- gunshot wounds - high-velocity and short-range shotgun injuries
- open fractures with neurovascular injury
- traumatic amputations
- open fractures over 8 hours old
- mass casualties (e.g., war or tornado victims)
 
Type IIIaAdequate soft-tissue coverage of a fractured bone despite extensive soft-tissue laceration or flaps, or high-energy trauma irrespective of the size of the wound 
Type IIIbExtensive soft-tissue injury loss with periosteal stripping and bone exposure. This is usually associated with massive contamination. 
Type IIIcOpen fracture associated with arterial injury requiring repair.