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The Evolution and Interpretation of the Gustilo and Anderson Classification.
Guang H Yim1, Joseph T Hardwicke2,3
1Department of Plastic Surgery, Derriford Hospital, Plymouth, United Kingdom.
The Journal of Bone and Joint Surgery. American Volume
|December 19, 2018
Summary
The Gustilo classification for open fractures has evolved over four decades, with subtle descriptor changes and modifications to subtypes impacting its interpretation and application in patient care.
Area of Science:
- Orthopedic Surgery
- Trauma Classification Systems
Background:
- The Gustilo classification is the standard for open fractures but has seen evolving interpretations.
- This study traces the historical evolution of the Gustilo classification in scientific literature over 40 years.
Purpose of the Study:
- To document the evolution of the Gustilo classification system.
- To analyze changes in its description and interpretation within the literature.
Main Methods:
- Systematic literature search of MEDLINE, Embase, and PubMed.
- Hand-searching references of relevant articles to identify further literature on the Gustilo classification.
Main Results:
- Initial search yielded 393 results; 56 articles were selected.
- An additional 67 articles were found through reference checking, totaling 123 relevant articles.
Conclusions:
- The Gustilo classification has undergone modifications since its inception, including subtle descriptor changes in the 1990s.
- Alternative classifications based on Gustilo have not gained widespread adoption.
- Recent modifications focus on Gustilo-IIIB subtypes for vascular injury outcomes, with long-term impact yet to be determined.
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