Patients were stratified according to study center and gustiloanderson fracture grade i or ii vs. In two patients with open fractures, the temporary use of an external fixation device was chosen, being the conversion to blocked intramedullary nail performed on the 10th day of postoperative followup. Limb salvage talectomy for 3c gustiloanderson fracture. Prevention of infection in the treatment of one thousand. After an explanation of the gustilo and anderson classification system and each patients pertinent history and physical examination, the physicians were asked to classify the fracture. In this work, the main objectives were to investigate the clinical characteristics and bacterial spectrum present in open fractures contaminated by seawater. Gustiloanderson classification article pdf available in clinical orthopaedics and related research 47012 october 2012 with 59 reads. Open fractures and incidence of infection in tertiary care. Infection still represents one of the most common challenge in the treatment of open fractures. Analysis of the characteristics of patients with open tibial fractures of gustilo and anderson type iii. We conducted a retrospective cohort study and included all patients with open fractures from 1st january, 2012, to 31st december, 2015, in our hospital. In the original study by gustilo and anderson, an overall infection rate of 2. Analysis of the characteristics of patients with open tibial. Distal third tibial shaft fracture with extensive soft tissue.
Comparative accuracy assessment of the gustilo and tscherne. A trial of wound irrigation in the initial management of open. Prevention of infection in the treatment of one thousand and twentyfive open fractures of long bones. Original article comparison of standard surgical debridement. Original article analysis of the characteristics of patients with open tibial fractures of gustilo and anderson type iii frederico carlos jana. Comparative accuracy assessment of the gustilo and tscherne classification systems as predictors of infection in open fracturesanalise. Original classification 2 gustilo and anderson prospectively followed more than 350 patients. The mean followup period of 15 patients was 18 months. All patients were treated using a small fragment adjunctive plate to hold the fracture reduced prior to. Demographic no % gustilo 1 gustilo 2 gustilo 3a, 3b, 3c total no. Type i an open fracture with a wound less than 1 cm long and clean. The fracture classification of gustilo and anderson, originally developed from experience with tibial fractures and frequently applied to long bones, has never been applied to injuries of the hand. To assess its interobserver reliability, 10 patients with open fractures had photographic slides taken of their wound before and after operative treatment. The analysis found that infection rates decreased in time because of changes in the management of open fractures.
In order to evaluate the applicability of this fracture classification to open fractures of the hand, 146 injured hands in 143 consecutive patients. Accurate assessment of the fracture can only be performed inside an operating theatre. Original article intra and extramedullary fixation combined. The fracture classification of gustilo and anderson correlated with the incidence of infection, length of hospital stay, return to work, and functional outcome in patients with open fractures of the hand. The patients quality of life after the treatment was examined with euroqol5d scoring system. Use of antimicrobials in the management of open fractures.
Prevention of infection in the treatment of one thousand and. The time, in hours, for administration of iv antibiotics intravenous from the time of injury was on average 3. All the fractures selected were of the diaphysis segment. The original study 16 included an initial retrospective evaluation, followed by a prospective test of the system that gustilo and anderson developed. Bone grafting via reamerirrigatoraspirator for nonunion of. Timing of wound closure in pediatric gustiloanderson grade ii and iiia open long bone fracture remain controversial.
The gustiloanderson classification system as predictor of. The pdf of the article you requested follows this cover page. Interobserver reliability in the gustilo and anderson. Original article open fractures and the incidence of. Gustiloanderson classification, clinical orthopaedics and. To arrive at the top five similar articles we use a wordweighted algorithm to compare words from the title and abstract of each citation. Type in at least one full word to see suggestions list. The primary variable was the total number of debridements until wound closure. Anderson gustilo classification, there were 3 cases defined as gustilo i, 5 as gustilo ii, 3 as gustilo iiia, 2 as gustilo iiib and 2 as gustilo iiic. This is an enhanced pdf from the journal of bone and joint surgery j bone joint surg am.
Patients with open tibia fractures treated with reamed intramedullary nail imn across a 10year period were evaluated. Demographic data according to the gustilo anderson classification. Patients were grouped based on the presence of seawater. Get a printable copy pdf file of the complete article. The gustilo open fracture classification system is the most commonly used classification system for open fractures. Adjuvant local antibiotic hydroxyapatite biocomposite in the. Which of the following descriptions matches this classification. This corrects the article gustiloanderson classification in volume 470 on page 3270. They categorized open injuries into the familiar three categories, based on wound size, level of contamination, and osseous injury, as follows. Original article factors associated with the outcome of open. No patient was administered iv antibiotic by the rescue team. Gustilo anderson classification radiology reference. It is designed to provide a unique, unequivocal definition of any injury and thereby, anderdon accurate comparison of cases.
The authors evaluation, mainly concerned with the capabilities and limitations of rpef, focuses on initial management, time to debridement, soft tissue coverage, ease of wound access. Interobserver reliability in the gustilo and anderson classification of open fractures. Gustiloanderson classification article pdf available in clinical orthopaedics and related research 47011. The gustilo and anderson classification system is widely used to categorize open fractures. Plate assisted intramedullary nailing of gustilo type iiib o. Our aims are 1 to determine the proportion of patients with these fractures whose wounds can be treated with early primary wound closure epwc. Aug 10, 2019 the original study 16 included an initial retrospective evaluation, followed by a prospective test of the system that gustilo and anderson developed. This system uses the amount of energy, the extent of softtissue injury and the extent of contamination for determination of fracture severity. The gustilo anderson classification, also known as the gustilo classification, is the most widely accepted classification system of open or compound fractures the grading system is used to guide management of compound fractures, with higher grade injuries associated with higher risk of complications. A descriptive study of open fractures contaminated by. Management of gustiloanderson type ii and iiia open long. To analyze the characteristics of patients with gustiloanderson type iii open tibial fractures treated at a tertiary care hospital in sao paulo between january 20 and august 2014. Most injuries involved the distal tibia n 8and were metaphyseal n 8.
Methods this was a crosssectional retrospective study. The gustilo anderson classification, also known as the gustilo classification, is the most widely accepted classification system of open or compound fractures the grading system is used to guide management of compound fractures, with higher grade injuries. Agreement among the various raters was determined by kappa analysis, which is the preferred measurement of interobserver reliability for nominal data such as classification schemes. It was created by ramon gustilo and anderson, and then further expanded by gustilo, mendoza, and williams. Sep 22, 2016 we sought to conduct the largest retrospective study to date of open tibia fractures and describe the incidence of complications and evaluate the potential predictive risk factors for complications. Secondary variables included time to wound closure and the total number of surgical procedures. This corrects the article gustilo anderson classification in volume 470 on page 3270. Management of gustiloanderson type ii and iiia open long bo. Gustilo anderson classification radiology reference article. Timing of wound closure in pediatric gustiloanderson grade ii and iiia open long bo. May 09, 2012 gustiloanderson classification gustiloanderson classification kim, paul. Original article fast pinless external fixation for open. At the end of the treatment, we analyzed the outcome, the way we treated the patients, and the treatment complications.
From these, 3 were type1 open fractures according to gustiloandersons classification. Plate assisted intramedullary nailing of gustilo type iiib. Foot fractures vary in severity with complex midfoot fractures having poor morbidity rates and high amputation rates. It is well known that most infections in open fractures are of nosocomial origin as causative microorganisms of infection are different to those found in initial smears. Gustilo initially does not recommend early wound closure and early fixation for grade iii fractures.
Interobserver reliability in the gustilo and anderson classi. Jan, 2020 gustilo anderson classification radiology reference article in response to that problem, these highenergy open fractures were further subclassified by gustilo et al. Rb gustilo and jt anderson open fractures of long bones. Followup was done at 1, 2, 3 months postoperatively, and then at 2 months intervals, to conduct clinical and radiographic examinations. This system uses the amount of energy, the extent of softtissue injury and the extent of contamination for determination.618 475 382 1471 366 1080 162 712 1432 851 28 1024 1010 61 602 1 1429 639 997 1220 769 348 1176 859 77 298 1135 1526 1231 658 709 409 616 109 1299 1379 43 80 1067