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Erschienen in: Clinical Orthopaedics and Related Research® 11/2012

01.11.2012 | In Brief

Gustilo-Anderson Classification

verfasst von: Paul H. Kim, MD, Seth S. Leopold, MD

Erschienen in: Clinical Orthopaedics and Related Research® | Ausgabe 11/2012

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Excerpt

Open fractures usually are high-energy injuries. This, along with the exposure of bone and deep tissue to the environment, leads to increased risk of infection, wound complications, and nonunion [12, 28, 31]. Antibiotics, surgical débridement, and internal fixation have improved outcomes of open fracture management in important ways, but the underlying principles for treating open fractures have remained the same since World War I: primary asepsis, adequate debridement, immobilization, and protection of wounds against disturbance and reinfection [25, 26]. …
Literatur
1.
Zurück zum Zitat Aro HT, Govender S, Patel AD, Hernigou P, Perera de Gregorio A, Popescu GI, Golden JD, Christensen J, Valentin A. Recombinant human bone morphogenetic protein-2: a randomized trial in open tibial fractures treated with reamed nail fixation. J Bone Joint Surg Am. 2011;93:801–808.PubMedCrossRef Aro HT, Govender S, Patel AD, Hernigou P, Perera de Gregorio A, Popescu GI, Golden JD, Christensen J, Valentin A. Recombinant human bone morphogenetic protein-2: a randomized trial in open tibial fractures treated with reamed nail fixation. J Bone Joint Surg Am. 2011;93:801–808.PubMedCrossRef
2.
Zurück zum Zitat Bergner M, Bobbitt RA, Pollard WE, Martin DP, Gilson BS. The sickness impact profile: validation of health status measure. Med Care. 1976;14:57–67.PubMedCrossRef Bergner M, Bobbitt RA, Pollard WE, Martin DP, Gilson BS. The sickness impact profile: validation of health status measure. Med Care. 1976;14:57–67.PubMedCrossRef
3.
Zurück zum Zitat Bhandari M, Guyatt GH, Swiontkowski MF, Schemitsch EH. Treatment of open fractures of the shaft of the tibia. J Bone Joint Surg Br. 2001;83:62–68.PubMedCrossRef Bhandari M, Guyatt GH, Swiontkowski MF, Schemitsch EH. Treatment of open fractures of the shaft of the tibia. J Bone Joint Surg Br. 2001;83:62–68.PubMedCrossRef
4.
Zurück zum Zitat Bowen TR, Widmaier JC. Host classification predicts infection after open fracture. Clin Orthop Relat Res. 2005;433:205–211.PubMedCrossRef Bowen TR, Widmaier JC. Host classification predicts infection after open fracture. Clin Orthop Relat Res. 2005;433:205–211.PubMedCrossRef
5.
Zurück zum Zitat Brumback RJ, Jones AL. Interobserver agreement in the classification of open fractures of the tibia: the results of a survey of two hundred and forty-five orthopaedic surgeons. J Bone Joint Surg Am. 1994;76:1162–1166.PubMed Brumback RJ, Jones AL. Interobserver agreement in the classification of open fractures of the tibia: the results of a survey of two hundred and forty-five orthopaedic surgeons. J Bone Joint Surg Am. 1994;76:1162–1166.PubMed
6.
Zurück zum Zitat Caudle RJ, Stern PJ. Severe open fractures of the tibia. J Bone Joint Surg Am. 1987;69:801–807.PubMed Caudle RJ, Stern PJ. Severe open fractures of the tibia. J Bone Joint Surg Am. 1987;69:801–807.PubMed
7.
Zurück zum Zitat Chapman MW, Gordon JE, Zissimos AG. Compression-plate fixation of acute fractures of the diaphyses of the radius and ulna. J Bone Joint Surg Am. 1989;71:159–169.PubMed Chapman MW, Gordon JE, Zissimos AG. Compression-plate fixation of acute fractures of the diaphyses of the radius and ulna. J Bone Joint Surg Am. 1989;71:159–169.PubMed
8.
Zurück zum Zitat Choudry U, Moran S, Karacor Z. Soft-tissue coverage and outcome of Gustilo grade IIIB midshaft tibia fractures: a 15 year experience. Plast Reconstr Surg. 2008;122:479–485.PubMedCrossRef Choudry U, Moran S, Karacor Z. Soft-tissue coverage and outcome of Gustilo grade IIIB midshaft tibia fractures: a 15 year experience. Plast Reconstr Surg. 2008;122:479–485.PubMedCrossRef
9.
Zurück zum Zitat Cohen J. A coefficient of agreement for nominal scales. Educ Psychol Meas. 1960;20:37–46.CrossRef Cohen J. A coefficient of agreement for nominal scales. Educ Psychol Meas. 1960;20:37–46.CrossRef
10.
Zurück zum Zitat Court Brown CM, Rimmer S, Prakash U, McQueen MM. The epidemiology of open long-bone fractures. Injury. 1998;29:529–534.PubMedCrossRef Court Brown CM, Rimmer S, Prakash U, McQueen MM. The epidemiology of open long-bone fractures. Injury. 1998;29:529–534.PubMedCrossRef
11.
Zurück zum Zitat Dellinger DP, Caplan ES, Weaver LD, Wertz MJ, Droppert BM, Hoyt N, Brumback R, Burgess A, Poka A, Benirschke SK, et al. Duration of preventive antibiotic administration for open extremity fractures. Arch Surg. 1988;123:333–339.PubMedCrossRef Dellinger DP, Caplan ES, Weaver LD, Wertz MJ, Droppert BM, Hoyt N, Brumback R, Burgess A, Poka A, Benirschke SK, et al. Duration of preventive antibiotic administration for open extremity fractures. Arch Surg. 1988;123:333–339.PubMedCrossRef
12.
Zurück zum Zitat Georgiadis GM, Behrens FF, Joyce MJ, Earle AS, Simmons AL. Open tibial fractures with severe soft-tissue loss: limb salvage compared with below-the-knee amputation. J Bone Joint Surg Am. 1993;75:1431–1441.PubMed Georgiadis GM, Behrens FF, Joyce MJ, Earle AS, Simmons AL. Open tibial fractures with severe soft-tissue loss: limb salvage compared with below-the-knee amputation. J Bone Joint Surg Am. 1993;75:1431–1441.PubMed
13.
Zurück zum Zitat Giannoudis PV, Papakostidis C, Roberts C. A review of the management of open fractures of the tibia and femur. J Bone Joint Surg Br. 2006;88:281–289.PubMedCrossRef Giannoudis PV, Papakostidis C, Roberts C. A review of the management of open fractures of the tibia and femur. J Bone Joint Surg Br. 2006;88:281–289.PubMedCrossRef
14.
Zurück zum Zitat Gosselin RA, Roberts I, Gillespie WJ. Antibiotics for preventing infection in open limb fractures. Cochrane Database Syst Rev. 2004:(1)CD003764. Gosselin RA, Roberts I, Gillespie WJ. Antibiotics for preventing infection in open limb fractures. Cochrane Database Syst Rev. 2004:(1)CD003764.
15.
Zurück zum Zitat Govender S, Csimma C, Genant HK, Valentin-Opran A, Amit Y, Arbel R, Aro H, Atar D, Bishay M, Borner MG, Chiron P, Choong P, Cinats J, Courtenay B, Feibel R, Geulette B, Gravel C, Hass N, Raschke M, Hammacher E, van der Velde D, Hardy P, Holt M, Josten C, Ketterl RL, Lindeque B, Lob G, Mathevon H, McCoy G, Marsh D, Miller R, Munting E, Oevre S, Nordsletten L, Patel A, Pohl A, Rennie W, Reynders R, Rommens PM, Rondia J, Rossouw WC, Daneel PJ, Ruff S, Ruter A, Santavirta S, Schildhauer TA, Gekle C, Schnettler R, Segal D, Seiler H, Snowdowne RB, Stapert J, Taglang G, Verdonk R, Vogels L, Weckbach A, Wentzensen A, Wisniewski T; BMP-2 Evaluation in Surgery for Tibial Trauma (BESST) Study Group. Recombinant human bone morphogenetic protein-2 for treatment of open tibial fractures: a prospective, controlled, randomized study of four hundred and fifty patients. J Bone Joint Surg Am. 2002;84:2123–2134. Govender S, Csimma C, Genant HK, Valentin-Opran A, Amit Y, Arbel R, Aro H, Atar D, Bishay M, Borner MG, Chiron P, Choong P, Cinats J, Courtenay B, Feibel R, Geulette B, Gravel C, Hass N, Raschke M, Hammacher E, van der Velde D, Hardy P, Holt M, Josten C, Ketterl RL, Lindeque B, Lob G, Mathevon H, McCoy G, Marsh D, Miller R, Munting E, Oevre S, Nordsletten L, Patel A, Pohl A, Rennie W, Reynders R, Rommens PM, Rondia J, Rossouw WC, Daneel PJ, Ruff S, Ruter A, Santavirta S, Schildhauer TA, Gekle C, Schnettler R, Segal D, Seiler H, Snowdowne RB, Stapert J, Taglang G, Verdonk R, Vogels L, Weckbach A, Wentzensen A, Wisniewski T; BMP-2 Evaluation in Surgery for Tibial Trauma (BESST) Study Group. Recombinant human bone morphogenetic protein-2 for treatment of open tibial fractures: a prospective, controlled, randomized study of four hundred and fifty patients. J Bone Joint Surg Am. 2002;84:2123–2134.
16.
Zurück zum Zitat 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. J Bone Joint Surg Am. 1976;58:453–458.PubMed 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. J Bone Joint Surg Am. 1976;58:453–458.PubMed
17.
Zurück zum Zitat Gustilo RB, Mendoza RM, Williams DN. Problems in management of type III (severe) open fractures: a new classification of type III open fractures. J Trauma. 1984;24:742–746.PubMedCrossRef Gustilo RB, Mendoza RM, Williams DN. Problems in management of type III (severe) open fractures: a new classification of type III open fractures. J Trauma. 1984;24:742–746.PubMedCrossRef
18.
Zurück zum Zitat Hansen ST Jr. The type-IIIC tibial fracture: salvage or amputation. J Bone Joint Surg Am. 1987;69:799–800.PubMed Hansen ST Jr. The type-IIIC tibial fracture: salvage or amputation. J Bone Joint Surg Am. 1987;69:799–800.PubMed
19.
Zurück zum Zitat Horn BD, Rettig ME. Interobserver reliability in the Gustilo and Anderson classification of open fractures. J Trauma. 1993;7:357–360. Horn BD, Rettig ME. Interobserver reliability in the Gustilo and Anderson classification of open fractures. J Trauma. 1993;7:357–360.
20.
Zurück zum Zitat Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159–174.PubMedCrossRef Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159–174.PubMedCrossRef
21.
Zurück zum Zitat Lenarz CJ, Watson JT, Moed BR, Israel H, Mullen JD, Macdonald JB. Timing of wound closure in open fractures based on cultures obtained after debridement. J Bone Joint Surg Am. 2010;92:1921–1926.PubMedCrossRef Lenarz CJ, Watson JT, Moed BR, Israel H, Mullen JD, Macdonald JB. Timing of wound closure in open fractures based on cultures obtained after debridement. J Bone Joint Surg Am. 2010;92:1921–1926.PubMedCrossRef
22.
Zurück zum Zitat Melvin JS, Dombroski DG, Torbert JT, Kovach SJ, Esterhai JL, Mehta S. Open tibial shaft fractures: I. Evaluation and initial wound management. J Am Acad Orthop Surg. 2010;18:10–19.PubMed Melvin JS, Dombroski DG, Torbert JT, Kovach SJ, Esterhai JL, Mehta S. Open tibial shaft fractures: I. Evaluation and initial wound management. J Am Acad Orthop Surg. 2010;18:10–19.PubMed
23.
Zurück zum Zitat Okike K, Bhattacharyya T. Trends in the management of open fractures: a critical analysis. J Bone Joint Surg Am. 2006;88:2739–2748.PubMedCrossRef Okike K, Bhattacharyya T. Trends in the management of open fractures: a critical analysis. J Bone Joint Surg Am. 2006;88:2739–2748.PubMedCrossRef
24.
Zurück zum Zitat Ostermann PA, Seligson D, Henry SL. Local antibiotic therapy for severe open fractures: a review of 1085 consecutive cases. J Bone Joint Surg Br. 1995;77:93–97.PubMed Ostermann PA, Seligson D, Henry SL. Local antibiotic therapy for severe open fractures: a review of 1085 consecutive cases. J Bone Joint Surg Br. 1995;77:93–97.PubMed
25.
Zurück zum Zitat Orr HW. The Orr method for wounds and compound fractures. JAMA. 1942;118:917.CrossRef Orr HW. The Orr method for wounds and compound fractures. JAMA. 1942;118:917.CrossRef
26.
Zurück zum Zitat Orr HW. Development of fracture surgery during the past 100 years. Clin Orthop. 1953;2:5–11.PubMed Orr HW. Development of fracture surgery during the past 100 years. Clin Orthop. 1953;2:5–11.PubMed
27.
Zurück zum Zitat Patzakis MJ, Wilkins J. Factors influencing infection rate in open fracture wounds. Clin Orthop Relat Res. 1989;243:36–40.PubMed Patzakis MJ, Wilkins J. Factors influencing infection rate in open fracture wounds. Clin Orthop Relat Res. 1989;243:36–40.PubMed
28.
Zurück zum Zitat Pollak AN, Jones AL, Castillo RC, Bosse MJ, MacKenzie EJ; LEAP Study Group. The relationship between time to surgical debridement and incidence of infection after open high-energy lower extremity trauma. J Bone Joint Surg Am. 2010;92:7–15. Pollak AN, Jones AL, Castillo RC, Bosse MJ, MacKenzie EJ; LEAP Study Group. The relationship between time to surgical debridement and incidence of infection after open high-energy lower extremity trauma. J Bone Joint Surg Am. 2010;92:7–15.
29.
Zurück zum Zitat Veliskakis KP. Primary internal fixation in open fractures of the tibial shaft: the problem of wound healing. J Bone Joint Surg Br. 1959:41:342–354.PubMed Veliskakis KP. Primary internal fixation in open fractures of the tibial shaft: the problem of wound healing. J Bone Joint Surg Br. 1959:41:342–354.PubMed
30.
Zurück zum Zitat Webb LX, Bosse MJ, Castillo RC, MacKenzie EJ; LEAP Study Group. Analysis of surgeon-controlled variables in the treatment of limb-threatening type III open tibial diaphyseal fractures. J Bone Joint Surg Am. 2007;89:923–928.PubMedCrossRef Webb LX, Bosse MJ, Castillo RC, MacKenzie EJ; LEAP Study Group. Analysis of surgeon-controlled variables in the treatment of limb-threatening type III open tibial diaphyseal fractures. J Bone Joint Surg Am. 2007;89:923–928.PubMedCrossRef
31.
Zurück zum Zitat Zalavras, CG, Marcus RE, Levin LS, Patzakis MJ. Management of open fractures and subsequent complications. J Bone Joint Surg Am. 2007;89:884–895.PubMedCrossRef Zalavras, CG, Marcus RE, Levin LS, Patzakis MJ. Management of open fractures and subsequent complications. J Bone Joint Surg Am. 2007;89:884–895.PubMedCrossRef
32.
Zurück zum Zitat Zalavras CG, Patzakis MJ. Open fractures: evaluation and managment. J Am Acad Orthop Surg. 2003;11:212–219.PubMed Zalavras CG, Patzakis MJ. Open fractures: evaluation and managment. J Am Acad Orthop Surg. 2003;11:212–219.PubMed
Metadaten
Titel
Gustilo-Anderson Classification
verfasst von
Paul H. Kim, MD
Seth S. Leopold, MD
Publikationsdatum
01.11.2012
Verlag
Springer-Verlag
Erschienen in
Clinical Orthopaedics and Related Research® / Ausgabe 11/2012
Print ISSN: 0009-921X
Elektronische ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-012-2376-6

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