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B-KBD
Soft Tissue Injury
1. Muscle
2. Vascular
3. Nerve
4. Tendon
5. Ligament
1
Open Fractures
Classification
Gustillo / Anderson
• Gustillo I
• skin lesion < 1cm
• skin perforation inside out
• minimal muscle contusion
• simple fracture pattern
• Gustillo II
• skin lesion > 1cm
• limited soft tissue damage
• no degloving
• simple fracture pattern
Gustillo RB (1984) J Trauma;24:742-6
Open Fx.
Gustillo / Anderson
• Gustillo III A
• Extensive soft tissue damage (skin, muscles,
neurovascular strucures) with still sufficient
bone coverage (periosteum)
• Gustillo III B
• Extensive soft tissue damage with periosteal
detachment and exposed bone
• Massive contomination of the wound
• Gustillo III C
• Vascular injury to be reconstructed
Gustillo I
Retrospective reviews
Advised the early recognition of the syndrome and
fasciotomies of the affected limbs
Compartment Syndrome
Tissue Survival
Muscle
3-4 hours - reversible changes
6 hours - variable damage
8 hours - irreversible changes
Nerve
2 hours - looses nerve conduction
4 hours - neuropraxia
8 hours - irreversible changes
Compartment Syndrome
Etiology
Arterial occlusion
Muscle rupture
Compartment Syndrome
Emergent Treatment