Gustilo–Anderson Classification

Name: Gustilo–Anderson Classification calculator — MedScore
Creator: Nabil Alzein

Open long-bone fractures by wound size, soft-tissue damage and vascular injury

Gustilo type

Tap the one that applies — its meaning opens right below.

I — wound < 1 cm, clean, minimal soft-tissue injury

II — wound > 1 cm, without extensive soft-tissue damage, flaps or avulsion

IIIA — extensive laceration or flaps, or high-energy trauma, but adequate soft-tissue coverage of the bone

IIIB — extensive soft-tissue loss with periosteal stripping and exposed bone, usually with massive contamination

IIIC — open fracture with an arterial injury requiring repair

About this score

When to use

Classifies open long-bone fractures by wound size, soft-tissue damage and vascular injury: types I–III, with type III subdivided into IIIA, IIIB and IIIC. ⁦[1, 2]⁩

Pearls and pitfalls

• Type III was subdivided because it was too inclusive: IIIA has adequate soft-tissue coverage, IIIB soft-tissue loss with periosteal stripping and bone exposure, IIIC an arterial injury needing repair. ⁦[2]⁩

• It came from a study of infection in 1,025 open fractures of long bones at one US trauma centre. ⁦[1]⁩

Summarised from the numbered sources under Evidence. Check the source before relying on a statement.

Evidence

[1] Original publication

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. Introduced types I–III; type III covered severe soft-tissue injury, segmental fractures and traumatic amputations.

Journal of Bone and Joint Surgery American, 1976

Open source

[2] Validation

Gustilo RB, Mendoza RM, Williams DN. Problems in the management of type III (severe) open fractures: a new classification of type III open fractures. Subdivided type III into IIIA (adequate soft-tissue coverage), IIIB (soft-tissue loss with periosteal stripping and bone exposure) and IIIC (arterial injury requiring repair); wound sepsis 4 / 52 / 42 % and amputation 0 / 16 / 42 %.

Journal of Trauma, 1984

Open source

[3] Guideline

Kim PH, Leopold SS. In brief: Gustilo-Anderson classification. Clinical Orthopaedics and Related Research 2012 — summary of the type definitions. Management (antibiotics, debridement, coverage) follows the local pathway.

Open source

Last reviewed: 2026-10

Report an error in this calculator

MedScore is an educational and clinical decision-support tool. It does not provide a diagnosis, a treatment, or a drug-dosing recommendation, and it does not replace clinical judgement or local guidelines. Confirm every result against the original source before acting on it. The treating clinician remains responsible for all decisions.