Gustilo and Anderson’s Classification of Open Fractures
| Type | Wound | Level of Contamination | Soft Tissue Injury | Bone Injury |
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| I | <1 cm long | Clean | Minimal | Simple, minimal comminution | | II | >1 cm long | Moderate | Moderate; some muscle damage | Moderate comminution | | IIIAa | Usually >10 cm | High | Severe with crushing | Usually comminuted; soft tissue coverage of bone possible | | IIIB | Usually >10 cm | High | Very severe loss of cover | Bone cover poor; usually requires soft tissue reconstructive surgery | | IIIC | Usually >10 cm | High | Very severe loss of cover and vascular injury requiring repair | Bone cover poor; usually requires soft tissue reconstructive surgery |
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a Segmental fractures, farmyard injuries, fractures occurring in a highly contaminated environment, shotgun wounds, or high-velocity gunshot wounds automatically result in classification as type III open fractures.
From RajasekaranS, DevendraA, RameshP, et al. Initial management of open fractures. In: TornettaP III, RicciWM, OstrumRF, et al., eds. Rockwood and Green’s Fractures in Adults. Vol 1. 9th ed. Philadelphia: Wolters Kluwer; 2020:484–530.