- The Oestern and Tscherne classification for open fractures uses wound size, level of contamination, and fracture pattern to grade open fractures
| Grade I |
- Open fractures with a small puncture wound without skin contusion
- negligible bacterial contamination
- low-energy fracture pattern
|
| Grade II |
- Open injuries with small skin and soft tissue contusions
- moderate contamination
- variable fracture patterns
|
| Grade III |
- Open fractures with heavy contamination
- extensive soft tissue damage
- often, associated arterial or neural injuries
|
| Grade IV |
- Open fractures with incomplete or complete amputations
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