Gustilo R B, Gruninger R P, Davis T
Department of Orthopedic Surgery, Hennepin County Medical Center, Minneapolis, MN 55415.
Orthopedics. 1987 Dec;10(12):1781-8.
Severe type III open fractures were subtyped according to the differences in prognosis for sepsis, amputation, and treatment: IIIA (adequate soft-tissue coverage of bone with extensive soft-tissue laceration or flaps), IIIB (extensive soft-tissue loss with periosteal stripping and bone exposure), and IIIC (arterial injury requiring repair). Analysis of 303 open fractures revealed a sepsis rate of 0% in type I, 2.5% in type II, and 13.7% in type III. The rate of amputation was 18.7%, and the rate of nonunion was 18.5% in type III open fractures. Type IIIA, IIIB, and IIIC open fractures had sepsis rates of 5%, 28%, and 8%, and amputation rates of 2.5%, 5.6%, and 25%, respectively. The overall wound sepsis rate in the 303 open fractures was 4.4%, and the nonunion rate was 8.6%.
严重的III型开放性骨折根据败血症、截肢和治疗预后的差异进一步细分：IIIA型（伴有广泛软组织撕裂或皮瓣的骨有足够的软组织覆盖）、IIIB型（广泛软组织缺失伴骨膜剥脱和骨外露）和IIIC型（需要修复的动脉损伤）。对303例开放性骨折的分析显示，I型骨折的败血症发生率为0%，II型为2.5%，III型为13.7%。III型开放性骨折的截肢率为18.7%，骨不连率为18.5%。IIIA型、IIIB型和IIIC型开放性骨折的败血症发生率分别为5%、28%和8%，截肢率分别为2.5%、5.6%和25%。303例开放性骨折的总体伤口败血症发生率为4.4%，骨不连率为8.6%。
