Classification of Open Fractures

00:02 Classification of open fractures.

00:04 How do we classify open fractures? Gustilo-Anderson.

00:07 What is Gustilo-Anderson IIIB? What's the highest grade of Gustilo-Anderson classification? IIIC, worst is IIIC.

00:25 Okay.

00:26 Even without extensive soft tissues or if you have a neurovascular compromise, it will go through IIIC.

00:33 If the patient has absent peripheral pulses, it will go to IIIC.

00:36 IIIB is periosteal stripping.

00:38 IIIB is when you have an opened fracture.

00:41 Okay, so Gustilo and Anderson classification, this has been asked a few times.

00:45 Yeah, the classification open fractures.

00:48 For llB.

00:53 That's right, yeah.

00:55 But you need to, this is mainly asked on a situation where to evaluate the urgency of surgery.

01:01 So, Gustilo-Anderson IIIC is a C41.

01:09 I'll go through that in a minute, I will just show you.

01:10 So, type 1 is a small wound let's say 1cm, type 2 is a large, well not large, something, anything more than 1 cm.

01:17 That's all you need to remember, more than 1 less than 1.

01:21 Type 3 is has got a IIIA, IIIB and IIIC.

01:26 So, IIIB is periosteal stripping.

01:28 Now, that is C41 as well.

01:32 But within 6 hours of injury, the other one is within an hour.

01:37 So that's what we are trying to find out how soon you need to take this patient to treat it.

01:53 Yes, that applies.

01:59 The only exception to that will be IIIC and you don't have time to transfer.

02:08 That's the only exception, otherwise you'll have to transfer.

02:13 For IIIC or any open? Well, not as good as 5 days, isn't it? 5 days, yeah.

02:22 Clearly, varies from patient and different protocols but 5 days.