![Open tibial shaft fracture pic Open tibial shaft fracture image](/sites/default/files/OpenfxG1.jpg) |
Gustilo-Anderson Grade I
- <1cm long
- clean wound
- minimal soft tissue injury
- simple fracture with minimal comminution
Treatment
- IV antibiotics. Cefazolin 2 grams IV Q8hrs for 3 days. (Wilkins J, Orthop Clin North Am 1991;22:433). Clindamycin 600mg IV Q8hrs in PCN allergic.
- Tetnus vaccination should be given if last vaccination was > 10yrs prior or unknown.
- Photograph the injury.
- Operative debridement.
|
![Grade 2 open distal radius fracture pic Grade 2 open distal radius fracture image](/sites/default/files/Grade-2.jpg) |
Gustilo-Anderson Grade II
- >1cm long
- moderate contamination
- moderate soft tissue damage
- moderate comminution
Treatment
- IV antibiotics. Cefazolin 2 grams IV Q8hrs + Levaquin* 500mg IV QD for 3 days. (Wilkins J, Orthop Clin North Am 1991;22:433). *(risk of renal failure with aminoglycosides). Clindamycin 600mg IV Q8hrs + Levaquin if PCN allergic.
- Tetnus vaccination should be given if last vaccination was > 10yrs prior or unknown or if >5yrs for severe contamination.
- Photograph the injury.
- Operative debridement.
|
![Grade 3A open tibial shaft fracture pic Grade 3A open tibial shaft fracture image](/sites/default/files/Grade-3a.jpg) |
Gustilo-Anderson Grade IIIA
- >10cm long
- highly contaminated
- Severe soft tissue injury with cruching, but wound soft tissue coverage is possible
- Usually comminuted
Treatment
- IV antibiotics. Cefazolin 2 grams IV Q8hrs + Levaquin* 500mg IV QD for 3 days. Add penicillin for any wound heavily contaminated with soil.(Wilkins J, Orthop Clin North Am 1991;22:433). *(risk of renal failure with aminoglycosides). Clindamycin 600mg IV Q8hrs + Levaquin if PCN allergic.
- Tetnus vaccination should be given if last vaccination was > 10yrs prior or unknown or if >5yrs for severe contamination.
- Photograph the injury.
- Operative debridement.
|
![Grade 3B open fracture pic Grade 3B open fracture image](/sites/default/files/Grade-3b.jpg) |
Gustilo-Anderson Grade IIIB
- >10cm long
- highly contaminated
- Very severe soft tissue injury usually requiring reconstructive surgery for coverage
- May be severely comminuted
- IV antibiotics. Cefazolin 2 grams IV Q8hrs + Levaquin* 500mg IV QD for 3 days. Add penicillin for any wound heavily contaminated with soil.(Wilkins J, Orthop Clin North Am 1991;22:433). *(risk of renal failure with aminoglycosides). Clindamycin 600mg IV Q8hrs + Levaquin if PCN allergic.
- Tetnus vaccination should be given if last vaccination was > 10yrs prior or unknown or if >5yrs for severe contamination.
- Photograph the injury.
- Operative debridement.
|
![Grade 3C open tibial shaft fracture pic Grade 3C open tibial shaft fracture image](/sites/default/files/OpenfxG3.jpg) |
Gustilo-Anderson Grade IIIC
- >10cm long
- highly contaminated
- Very severe soft tissue injury with vascular injury requiring repair; usually requires reconstructive surgery for coverage
- May be severely comminuted
- IV antibiotics. Cefazolin 2 grams IV Q8hrs + Levaquin* 500mg IV QD for 3 days. Add penicillin for any wound heavily contaminated with soil.(Wilkins J, Orthop Clin North Am 1991;22:433). *(risk of renal failure with aminoglycosides). Clindamycin 600mg IV Q8hrs + Levaquin if PCN allergic.
- Tetnus vaccination should be given if last vaccination was > 10yrs prior or unknown or if >5yrs for severe contamination.
- Photograph the injury.
- Operative debridement.
|
|
|