A patient with history of RTA is seen at emergency department. He has an open injury of Gustilo- Anderson type III B. What does this indicate?

ANS. CGustilo and Anderson classification system of open fracturesClassification DescriptionType 1* Puncture wound of less than or equal to 1 cm with minimal soft tissure injury* Minimal wound contamination or muscle crushingType 2* Wound is greater than 1 cm in length* Moderate soft-tissue injury* Soft tissue coverage of the bone is adequate* Comminution is minimalType 3a* Extensive soft tissue damage* Includes massively contaminated, serverely* comminuted, or segmental fractures* Soft tissue coverage of the bone is adequateType 3b* Extensive soft tissue damage with periosteal stripping and bone exposure* Usually severely contaminated and comminuted* Flap coverage is required to provide soft tissue coverageType 3c* Associated with an arterial injury requiring repair for limb salvage