A 22-year-old construction worker falls from scaffolding, sustaining an open fracture of the right tibial shaft with a 4 cm clean skin wound and minimal periosteal stripping. According to the Gustilo-Anderson classification, what grade is this open fracture?

Answer and explanation

Correct answer: C. Type II

  1. Step 1: Gustilo-Anderson classification of open fractures:
  2. Step 2: Type I: Clean puncture wound < 1 cm with minimal contamination.
  3. Step 3: Type II: Laceration between 1 cm and 10 cm with moderate soft-tissue damage and minimal periosteal stripping.
  4. Step 4: Type III: Wound > 10 cm with extensive soft-tissue injury or contamination (subdivided into A, B with periosteal stripping, C with arterial injury requiring repair).
  5. Step 5: A 4 cm clean wound without periosteal stripping is Grade II.
Answer
Type II.
Why not the others: 'Type I' is < 1 cm; 'Type III-A' has extensive soft tissue damage despite adequate bone coverage; 'Type III-C' requires an arterial injury requiring revascularization.

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