Gustillo & Anderson

(J Bone Joint Surg, 58A:453, 1976)
Type 1 open fracture with <1 cm without extensive soft tissue damage.

Type 2 – open fracture >1 cm without extensive soft tissue damage. Crushing injury with moderate comminution, and contamination

Type 3 – open fracture >10 cm with extensive soft tissue damage. Severe comminution associated, high contamination. Type 3 include Gunshot wounds, farm injuries, arterial injuries, motor vehicle accidents (MVA).
3A – adequate soft tissue coverage
3B – periosteal stripping and bone exposure. Poor soft tissue coverage
3C – High arterial injury, requiring vascular repair. High amutation risk.