A motorcyclist sustains an open fracture of the tibial shaft with a wound over 10 cm, extensive soft tissue stripping, and exposed bone that requires a local flap for coverage. According to the Gustilo and Anderson classification, this is:
- A Type IIIA
- B Type IIIC
- C Type IIIB ✓
- D Type II
Correct answer: C. Type IIIB
Explanation
Type III open fractures have extensive soft tissue damage regardless of wound size. Type IIIA has adequate soft tissue coverage despite exposed bone, IIIB requires a flap or graft for coverage, and IIIC has an associated arterial injury requiring repair. The need for soft tissue reconstruction here places it squarely in IIIB. Type II is wrong because wounds over 1 cm with severe contamination or soft tissue loss are upgraded to Type III.
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
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Written and medically reviewed by the StethoPrep medical team.