A farmer sustains an open wound over the left tibia measuring 12 cm after a machinery injury. There is extensive periosteal stripping and contusion of the surrounding muscle, but the exposed bone can be covered with local soft tissue at debridement. Distal pulses are intact and there is no crush injury to the foot. According to the Gustilo and Anderson classification, this is:

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

Explanation

Any open tibial fracture with a wound longer than 10 cm, extensive soft tissue stripping and periosteal denudation is automatically Grade III regardless of energy. Grade IIIA has adequate soft tissue coverage available locally, IIIB requires a flap or graft for coverage, and IIIC denotes an associated arterial injury needing repair. Here coverage is achievable with local tissue and pulses are intact, so the injury is IIIA and not IIIB.

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.