Brumback and Jones surveyed 245 orthopaedic surgeons to measure how reliably the Gustilo-Anderson classification is applied to open tibial fractures. Surgeons viewed twelve standardized videotaped cases — including wound appearance, physical exam, radiographs, and operative débridement — and assigned a classification type to each.
When using Gustilo-Anderson type to guide treatment or interpret literature, recognize that even experienced trauma surgeons disagree on classification roughly one-third of the time — treat the wound you see, not just the grade you assign.
This paper is the foundational evidence that Gustilo-Anderson type alone is an unreliable basis for cross-institutional outcome comparisons, which has driven ongoing efforts to develop more objective open-fracture classification systems.
Brumback and Jones surveyed 245 orthopaedic surgeons to measure how reliably the Gustilo-Anderson classification is applied to open tibial fractures. Surgeons viewed twelve standardized videotaped cases — including wound appearance, physical exam, radiographs, and operative débridement — and assigned a classification type to each.
When using Gustilo-Anderson type to guide treatment or interpret literature, recognize that even experienced trauma surgeons disagree on classification roughly one-third of the time — treat the wound you see, not just the grade you assign.
This paper is the foundational evidence that Gustilo-Anderson type alone is an unreliable basis for cross-institutional outcome comparisons, which has driven ongoing efforts to develop more objective open-fracture classification systems.