In the Gustilo and Anderson classification of open fractures, a Type IIIB fracture is defined by:
- A A wound larger than 10 cm with extensive soft tissue loss requiring a flap for coverage ✓
- B A wound smaller than 10 cm without extensive soft tissue damage
- C Any open fracture with an associated arterial injury requiring repair
- D A wound larger than 10 cm with adequate soft tissue coverage by local tissue
Correct answer: A. A wound larger than 10 cm with extensive soft tissue loss requiring a flap for coverage
Explanation
Gustilo Type IIIB denotes extensive soft tissue loss with periosteal stripping and bone exposure such that adequate soft tissue coverage demands a local or free flap. Type IIIA has sufficient soft tissue despite the large wound, which eliminates option D. An arterial injury requiring repair defines Type IIIC, so option C describes a higher grade. Option B approximates a Type II fracture, which has a moderate wound without extensive soft tissue damage.
Reference: Rockwood and Green's Fractures in Adults, 9th ed.
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