Evidence brief
Prevention of Infection in the Treatment of One Thousand and Twenty-five Open Fractures of Long Bones
Established the Gustilo-Anderson classification for open fractures (Type I, II, III)
Type III later subdivided (IIIA, IIIB, IIIC) in 1984 paper
Infection rates: Type I 0-2%, Type II 2-10%, Type III 10-50%
Based on wound size, contamination, and soft tissue injury
1,025 open fractures analyzed
This classification system remains the global standard for communicating severity of open fractures and guides antibiotic prophylaxis duration, timing of wound closure, and need for soft tissue coverage.
Must know cold: Type I (<1cm, minimal contamination), Type II (1-10cm, moderate contamination), Type IIIA (adequate soft tissue despite high energy), Type IIIB (requires flap), Type IIIC (arterial injury requiring repair). Know the associated infection rates.
Gustilo RB, Anderson JT. Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: retrospective and prospective analyses. J Bone Joint Surg Am. 1976;58(4):453-458.
Level IV
Case series or case reports