Acute and Complex Musculoskeletal Injury

Question 1

What is a type I Gustillo-Anderson fracture?

Answer 1

Open fracture
Clean wound
Less than 1 cm in length

Question 2

What is a type II Gustillo-Anderson fracture?

Answer 2

Open fracture
Wound >1 cm and <10 cm
No extensive
- Soft tissue damage
- Flaps
- Avulsions

Question 3

What is a type IIIA Gustillo-Anderson fracture?

Answer 3

Adequate periosteal coverage of bone

Extensive soft tissue laceration/damage

Question 4

What is a type IIIB Gustillo-Anderson fracture?

Answer 4

Extensive soft tissue loss
Periosteal stripping
Bone damage
Usually associated with massive contamination
Often needs further soft tissue coverage procedure

Question 5

What is a type IIIC Gustillo-Anderson fracture?

Answer 5

Arterial injury needing repair, irrespective of degree of soft tissue injury

Question 6

What is the antibiotic management of open fractures?

Answer 6

Is there severe tissue damage/clinical evidence of infection?

• No
  
  • Has debridement occurred within 8 hours of injury?
    
    • Yes > give systemic Abx prophylaxis for 24-72 hours
    • No > give presumptive therapy for 7 days
• Yes > give empirical therapy for 7 days unless bone infection established - prolonged treatment in this case