The initial evaluation for<unk> s is to rule out any other life-threatening injuries. Advanced Trauma Life Support (ATLS) is the initial protocol to rule out such injuries. Once the patient is stabilised, orthopedic injuries can be evaluated. Mechanism of injury is important to know the amount energy that is transferred to the patient and the level of contamination. Every limb should be exposed to evaluate any other hidden injuries. Characteristics of the wound should be noted in detail. Neurology and the vascular status of the affected limb are important to rule out any nerve or blood vessels injuries. High index of suspicion of compartment syndrome should be maintained for leg and forearm fractures. There are a number of classification systems attempting to categorise<unk> s such as Gustilo<unk>  classification, Tscherne classification, and Müller AO Classification of fractures. However, Gustilo<unk>  classification is the most commonly used classification system. Gustilo system grades the fracture according to energy of injury, soft tissue damage, level of contamination, and comminution of fractures. The higher the grade, the worse the outcome of the fracture. + Gustilo<unk>  Classification Gustilo Grade Definition I<unk> , clean wound, wound 1 cm but < 10 cm in length without extensive soft-tissue damage, flaps, avulsions IIIA<unk>  with adequate soft tissue coverage of a fractured bone despite extensive soft tissue laceration or flaps, or high-energy trauma (gunshot and farm injuries) regardless of the size of the wound IIIB<unk>  with extensive soft-tissue loss and periosteal stripping and bone damage. Usually associated with massive contamination. Will often need further soft-tissue coverage procedure (i.e. free or rotational flap) IIIC<unk>  associated with an arterial injury requiring repair, irrespective of degree of soft-tissue injury. However, Gustilo system is not without its limitations. The system has limited interobserver reliability at 50% to 60%. The size of injury on the skin surface does not necessarily reflect the extent of deep underlying soft tissue injury. Therefore, the true grading of Gustilo can only be done in operating theatre.
Open fracture
Tennis injuries
Chance fracture
Intracapsular fracture
Plantar fascial rupture
Burst fracture
Intraarticular fracture
Occult fracture