gustilo classification

Management

Definition

 

Tibial facture with break in skin

- open wound communicating with fracture or haematoma

 

Patient is immediately at higher risk of deep infection

 

Diagnosis

 

Wound continuously oozes dark red fracture haematoma

 

Epidemiology

 

Up to 1/4 of tibia fractures open

 

Gustilo and Anderson Classification

 

Grade 1

- wound < 1cm

- usually inside out

Management

Incidence

 

Knee > Hip

- superficial position

- limited cover of well vascularised muscle 

- watershed area of skin blood supply anterior to the skin incision 

- much increased in fully constrained prosthesis 

 

Ideal < 1%

 

Risk Factors

 

Increased with

- revision

- prior infection

- RA / Psoriatic arthropathy

- DM