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Grading of open fractures

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Grading is important in determining the management of open fractures:

  • Minor / Grade I - small punctate wound less than 1 cm associated with low velocity trauma. Minimal soft tissue injury. No crushing. No comminution.
  • Moderate / Grade II - wounds which are extensive in length and width but with relatively little soft tissue damage, and only moderate crushing or comminution.
  • Major / Grade III - wounds of moderate or massive size with considerable soft tissue injury and/or foreign body contamination:
    • III A - sufficient soft tissue to cover the fracture
    • III B - insufficient tissue to cover the fracture; also periosteal stripping and severe comminution
    • III C - arterial damage requiring repair. Degree of soft tissue damage not considered

Less than 2% wound infection in grade I; more than 10% in grade II. High velocity injuries are III B or III C although the external wound may be small.

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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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