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. Interobserver reliability in the gustilo and anderson. Gustiloanderson classification article pdf available in clinical orthopaedics and related research 47012 october 2012 with 59 reads. This is an enhanced pdf from the journal of bone and joint surgery j bone joint surg am. Infection still represents one of the most common challenge in the treatment of open fractures. Demographic data according to the gustilo anderson classification. Prevention of infection in the treatment of one thousand and. Timing of wound closure in pediatric gustiloanderson grade ii and iiia open long bone fracture remain controversial. It was created by ramon gustilo and anderson, and then further expanded by gustilo, mendoza, and williams. Rb gustilo and jt anderson open fractures of long bones.
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. Open fractures and incidence of infection in tertiary care. Analysis of the characteristics of patients with open tibial fractures of gustilo and anderson type iii. Type in at least one full word to see suggestions list.
Original article fast pinless external fixation for open. The mean followup period of 15 patients was 18 months. Original article open fractures and the incidence of. Original article factors associated with the outcome of open. All patients were treated using a small fragment adjunctive plate to hold the fracture reduced prior to. Analysis of the characteristics of patients with open tibial. Patients with open tibia fractures treated with reamed intramedullary nail imn across a 10year period were evaluated. Adjuvant local antibiotic hydroxyapatite biocomposite in the. 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. In the original study by gustilo and anderson, an overall infection rate of 2. 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. Get a printable copy pdf file of the complete article.
Type i an open fracture with a wound less than 1 cm long and clean. The pdf of the article you requested follows this cover page. 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. Which of the following descriptions matches this classification. Foot fractures vary in severity with complex midfoot fractures having poor morbidity rates and high amputation rates. Patients were grouped based on the presence of seawater.
We conducted a retrospective cohort study and included all patients with open fractures from 1st january, 2012, to 31st december, 2015, in our hospital. Full text is available as a scanned copy of the original print version. The original study 16 included an initial retrospective evaluation, followed by a prospective test of the system that gustilo and anderson developed. Timing of wound closure in pediatric gustiloanderson grade ii and iiia open long bo. Original article analysis of the characteristics of patients with open tibial fractures of gustilo and anderson type iii frederico carlos jana. To assess its interobserver reliability, 10 patients with open fractures had photographic slides taken of their wound before and after operative treatment. This, along with the exposure of bone and deep tissue to the environment, leads to increased risk of infection, wound complications. Plate assisted intramedullary nailing of gustilo type iiib o.
Interobserver reliability in the gustilo and anderson classification of open fractures. All the fractures selected were of the diaphysis segment. In this work, the main objectives were to investigate the clinical characteristics and bacterial spectrum present in open fractures contaminated by seawater. Original classification 2 gustilo and anderson prospectively followed more than 350 patients. Gustiloanderson classification, clinical orthopaedics and. Management of gustiloanderson type ii and iiia open long bo. In order to evaluate the applicability of this fracture classification to open fractures of the hand, 146 injured hands in 143 consecutive patients. A descriptive study of open fractures contaminated by. Most injuries involved the distal tibia n 8and were metaphyseal n 8. 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. The patients quality of life after the treatment was examined with euroqol5d scoring system. Our aims are 1 to determine the proportion of patients with these fractures whose wounds can be treated with early primary wound closure epwc. Jan, 2020 gustilo anderson classification radiology reference article in response to that problem, these highenergy open fractures were further subclassified by gustilo et al.
Plate assisted intramedullary nailing of gustilo type iiib. Original article intra and extramedullary fixation combined. Use of antimicrobials in the management of open fractures. Gustilo initially does not recommend early wound closure and early fixation for grade iii fractures. Bone grafting via reamerirrigatoraspirator for nonunion of. Interobserver reliability in the gustilo and anderson classi. 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. Distal third tibial shaft fracture with extensive soft tissue.
The gustilo and anderson classification system is widely used to categorize open fractures. Accurate assessment of the fracture can only be performed inside an operating theatre. Prevention of infection in the treatment of one thousand. Management of gustiloanderson type ii and iiia open long. They categorized open injuries into the familiar three categories, based on wound size, level of contamination, and osseous injury, as follows. The primary variable was the total number of debridements until wound closure. Comparative accuracy assessment of the gustilo and tscherne.
Followup was done at 1, 2, 3 months postoperatively, and then at 2 months intervals, to conduct clinical and radiographic examinations. Gustilo anderson classification radiology reference article. Original article comparison of standard surgical debridement. Demographic no % gustilo 1 gustilo 2 gustilo 3a, 3b, 3c total no. 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.
It is designed to provide a unique, unequivocal definition of any injury and thereby, anderdon accurate comparison of cases. The time, in hours, for administration of iv antibiotics intravenous from the time of injury was on average 3. 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. May 09, 2012 gustiloanderson classification gustiloanderson classification kim, paul. Analysis of the characteristics of patients with open tibial fractures of.
No patient was administered iv antibiotic by the rescue team. This system uses the amount of energy, the extent of softtissue injury and the extent of contamination for determination of fracture severity. To arrive at the top five similar articles we use a wordweighted algorithm to compare words from the title and abstract of each citation. Comparative accuracy assessment of the gustilo and tscherne classification systems as predictors of infection in open fracturesanalise. Limb salvage talectomy for 3c gustiloanderson fracture. 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. This corrects the article gustilo anderson classification in volume 470 on page 3270.
At the end of the treatment, we analyzed the outcome, the way we treated the patients, and the treatment complications. A trial of wound irrigation in the initial management of open. The analysis found that infection rates decreased in time because of changes in the management of open fractures. Secondary variables included time to wound closure and the total number of surgical procedures. The gustilo open fracture classification system is the most commonly used classification system for open fractures. Methods this was a crosssectional retrospective study. Patients were stratified according to study center and gustiloanderson fracture grade i or ii vs. Gustiloanderson classification article pdf available in clinical orthopaedics and related research 47011.
215 1061 1573 1015 1226 183 370 1629 477 781 674 492 614 1045 197 1274 1426 721 944 678 522 1456 606 1072 15 199 1014 361 1472 390 379 323 410 1235 803 552 325 661 1427 753 641 30