According to the Gustilo-Anderson classification, a Type III open fracture is further subdivided into three grades. Which of the following best describes Type IIIC?

Question

Accepted Answer

C. Fracture with extensive soft tissue injury and vascular injury requiring repair. ## Gustilo-Anderson Classification of Open Fractures

**Key Point:** Type IIIC is defined by the presence of vascular injury requiring repair, regardless of the degree of soft tissue damage or contamination.

### Type III Subdivisions

| Grade | Soft Tissue Injury | Contamination | Vascular Status | Prognosis |
|-------|-------------------|----------------|-----------------|----------|
| **IIIA** | Extensive but adequate coverage | High | Intact | Better |
| **IIIB** | Extensive with periosteal stripping | High | Intact | Guarded |
| **IIIC** | Variable | Variable | **Vascular injury requiring repair** | **Poor** |

**High-Yield:** Type IIIC is the most serious category because vascular compromise threatens limb viability. The presence of vascular injury is the defining criterion, not the extent of soft tissue damage.

**Clinical Pearl:** Type IIIC fractures have the highest amputation rates (up to 50%) and require urgent vascular surgery consultation alongside orthopedic management. Vascular repair must be attempted within 6–8 hours for optimal limb salvage.

**Mnemonic:** **VASCULAR = IIIC** — if there's a vascular injury in an open fracture, it's automatically Type IIIC, the most severe category.

![Open Fracture — Gustilo Classification diagram](https://mmcphlazjonnzmdysowq.supabase.co/storage/v1/object/public/blog-images/explanation/3904.webp)

Answer

A. Fracture with adequate soft tissue coverage despite extensive contamination

Answer

B. Fracture with bone loss exceeding 50% of the bone length

Answer

D. Fracture with minimal soft tissue injury and low contamination risk

According to the Gustilo-Anderson classification, a Type III open fracture is further subdivided into three grades. Which of the following best describes Type IIIC?

Explanation

Gustilo-Anderson Classification of Open Fractures

Type III Subdivisions

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Grade	Soft Tissue Injury	Contamination	Vascular Status	Prognosis
IIIA	Extensive but adequate coverage	High	Intact	Better
IIIB	Extensive with periosteal stripping	High	Intact	Guarded
IIIC	Variable	Variable	Vascular injury requiring repair	Poor