An open fracture of the tibia with a wound of 8 cm, moderate contamination, severe periosteal stripping, and arterial injury requiring repair is classified according to Gustilo-Anderson as:

• A Type I
• B Type IIIC ✓
• C Type II
• D Type IIIB

Explanation

Gustilo-Anderson classification: Type I = wound <1 cm, clean, low-energy; Type II = 1–10 cm, moderate contamination, no severe periosteal stripping; Type IIIA = >10 cm or severe contamination/high-energy but adequate soft tissue coverage; Type IIIB = >10 cm with extensive periosteal stripping, bone exposed, requiring flap coverage; Type IIIC = any size wound with arterial injury requiring vascular repair. The presence of arterial injury requiring repair automatically classifies the fracture as Type IIIC regardless of wound size or contamination level. IIIC fractures have the highest amputation rate (up to 50%) and require an orthoplastic approach with urgent vascular repair followed by fracture stabilization.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

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Written and medically reviewed by the StethoPrep medical team.