According to the Gustilo and Anderson classification of open tibial fractures, a wound with extensive soft tissue stripping, periosteal denudation, and massive contamination that will require a local or free flap for coverage, but with an intact dorsalis pedis pulse, is classified as:

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

Explanation

Type III open fractures denote severe soft tissue injury regardless of wound size. IIIA allows adequate soft tissue coverage despite extensive laceration or flaps, IIIB requires a rotational or free flap because of exposed bone and periosteal stripping, and IIIC adds any arterial injury requiring repair. An intact pedal pulse excludes IIIC here, which is the key discriminating fact.

Reference: Rockwood and Green's Fractures in Adults, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.