# Gustilo-Anderson — Gustilo-Anderson classification of open fractures

> Grades open (compound) fractures by wound size, soft-tissue injury, contamination, and vascular status to guide antibiotics and predict infection.

**Situação:** vigente · **Órgão:** Musculoesquelético · **Órgão emissor:** Gustilo & Anderson · **Versão:** 1984 (Gustilo-Mendoza-Williams) · **Ano:** 1976

## Procedência e vigência
- Família: léxico
- Tipo de lógica: flat
- Modalidade: XR, CT
- Fonte primária: Sop JL, Sop A. Open Fracture Management (StatPearls) (2023) — https://www.ncbi.nlm.nih.gov/books/NBK448083/
- Última verificação: 2026-06-26
- Última checagem: 2026-06-26

## Categorias

| Código | Rótulo | Critérios | Conduta | Risco | Localizador | Verificado |
| --- | --- | --- | --- | --- | --- | --- |
| I | Type I | Low-energy open fracture with a clean wound under 1 cm and minimal soft-tissue damage. | Gram-positive coverage (e.g. cefazolin or cefuroxime) plus irrigation and debridement. | — | StatPearls 'Open Fracture Management' (NBK448083), classification/wound-examination text: type I = low energy, wound <1 cm, minimal soft-tissue damage; gram-positive antibiotic coverage. | ✓ |
| II | Type II | Low-to-moderate energy open fracture with a wound greater than 1 cm and moderate soft-tissue and muscle damage. | Gram-positive antibiotic coverage, as for type I, with irrigation and debridement. | — | StatPearls NBK448083, classification text: type II = low-to-moderate energy, wound >1 cm, moderate soft-tissue/muscle damage; gram-positive coverage. | ✓ |
| IIIA | Type IIIA | High-energy open fracture with a wound usually greater than 10 cm or severe crushing soft-tissue damage, but with adequate soft-tissue coverage of the exposed bone. | Add gram-negative coverage (e.g. an aminoglycoside such as gentamicin) to gram-positive coverage; high-dose penicillin if fecal/clostridial contamination is suspected. | — | StatPearls NBK448083: type III = high-velocity, wounds >10 cm; IIIA severe crushing soft-tissue damage; type III antibiotics add gram-negative (aminoglycoside) and penicillin for contamination. | ✓ |
| IIIB | Type IIIB | High-energy open fracture with significant loss of soft-tissue coverage and periosteal stripping, leaving exposed bone that requires a soft-tissue flap for coverage. | Gram-positive plus gram-negative coverage with irrigation/debridement; soft-tissue flap reconstruction for coverage. | — | StatPearls NBK448083: IIIB = significant loss of tissue coverage requiring a flap; type III combined gram-positive and gram-negative antibiotic regimen. | ✓ |
| IIIC | Type IIIC | Open fracture with an associated arterial injury requiring repair, regardless of wound size. | Gram-positive plus gram-negative coverage and urgent vascular repair. | By definition involves an arterial injury requiring repair, carrying the greatest limb-loss/amputation risk among the grades. | StatPearls NBK448083: IIIC = significant soft-tissue injury with vascular injury requiring repair; type III antibiotic regimen. | ✓ |

### Citações por categoria
- **I**: Sop JL, Sop A. Open Fracture Management (StatPearls) (2023) — https://www.ncbi.nlm.nih.gov/books/NBK448083/ · StatPearls 'Open Fracture Management' (NBK448083), classification/wound-examination text: type I = low energy, wound <1 cm, minimal soft-tissue damage; gram-positive antibiotic coverage.
- **II**: Sop JL, Sop A. Open Fracture Management (StatPearls) (2023) — https://www.ncbi.nlm.nih.gov/books/NBK448083/ · StatPearls NBK448083, classification text: type II = low-to-moderate energy, wound >1 cm, moderate soft-tissue/muscle damage; gram-positive coverage.
- **IIIA**: Sop JL, Sop A. Open Fracture Management (StatPearls) (2023) — https://www.ncbi.nlm.nih.gov/books/NBK448083/ · StatPearls NBK448083: type III = high-velocity, wounds >10 cm; IIIA severe crushing soft-tissue damage; type III antibiotics add gram-negative (aminoglycoside) and penicillin for contamination.
- **IIIB**: Sop JL, Sop A. Open Fracture Management (StatPearls) (2023) — https://www.ncbi.nlm.nih.gov/books/NBK448083/ · StatPearls NBK448083: IIIB = significant loss of tissue coverage requiring a flap; type III combined gram-positive and gram-negative antibiotic regimen.
- **IIIC**: Sop JL, Sop A. Open Fracture Management (StatPearls) (2023) — https://www.ncbi.nlm.nih.gov/books/NBK448083/ · StatPearls NBK448083: IIIC = significant soft-tissue injury with vascular injury requiring repair; type III antibiotic regimen.

## Histórico de versões

| Data | Evento | Detalhe | Situação |
| --- | --- | --- | --- |
| 1984-01-01 | revised | Type III subdivided into IIIA, IIIB, and IIIC (Gustilo, Mendoza, Williams). | confirmed |


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> Conteúdo de referência reescrito. Confira a publicação primária vigente. Não é dispositivo médico nem substitui o julgamento clínico. O radiologista responsável pelo laudo permanece o autor e o responsável.

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