Open fractures and their management MCQs(Gustilo classification)

By: Prof. Dr. Fazal Rehman Shamil | Last updated: September 28, 2024

What is an open fracture?
A) A fracture where the skin is intact
B) A fracture with a break in the skin
C) A fracture with no displacement
D) A fracture that heals without treatment
Answer: B) A fracture with a break in the skin

What is the primary concern in managing open fractures?
A) Stabilizing the fracture
B) Preventing infection
C) Pain management
D) Restoring mobility
Answer: B) Preventing infection

What classification system is used for open fractures?
A) AO Classification
B) Gustilo Classification
C) Neer Classification
D) Salter-Harris Classification
Answer: B) Gustilo Classification

In the Gustilo classification, what does Type I indicate?
A) A fracture with a large soft tissue injury
B) A clean wound less than 1 cm
C) A fracture with extensive damage
D) A fracture with an associated vascular injury
Answer: B) A clean wound less than 1 cm

What is characteristic of a Type II open fracture in the Gustilo classification?
A) A wound greater than 2 cm with moderate soft tissue damage
B) A clean wound less than 1 cm
C) A fracture with bone loss
D) A fracture with a contaminated wound
Answer: A) A wound greater than 2 cm with moderate soft tissue damage

Which Gustilo classification type includes fractures with extensive soft tissue loss?
A) Type I
B) Type II
C) Type IIIA
D) Type IIIB
Answer: D) Type IIIB

What defines a Type IIIA open fracture?
A) Contaminated with extensive tissue loss
B) No soft tissue coverage over bone
C) Adequate soft tissue coverage despite extensive injury
D) A clean wound less than 1 cm
Answer: C) Adequate soft tissue coverage despite extensive injury

In the management of open fractures, what is the first step after injury?
A) Administer antibiotics
B) Clean the wound
C) Stabilize the fracture
D) Obtain imaging
Answer: A) Administer antibiotics

What is the recommended timing for surgical intervention in open fractures?
A) Within 24 hours
B) Within 6 hours
C) Within 48 hours
D) As soon as possible
Answer: D) As soon as possible

Which of the following is a common complication of open fractures?
A) Osteoporosis
B) Nonunion
C) Malunion
D) Infection
Answer: D) Infection

What is the role of irrigation in the management of open fractures?
A) To stabilize the fracture
B) To remove debris and reduce contamination
C) To promote healing
D) To manage pain
Answer: B) To remove debris and reduce contamination

What type of fixation is often used for Type III open fractures?
A) Intramedullary nailing
B) External fixation
C) Casting
D) Plate and screws
Answer: B) External fixation

What is an essential part of post-operative care for open fractures?
A) Regular dressing changes
B) Complete immobilization
C) Early mobilization
D) Avoiding weight-bearing activities
Answer: A) Regular dressing changes

What is the preferred antibiotic regimen for open fractures?
A) Broad-spectrum antibiotics
B) Only topical antibiotics
C) No antibiotics needed
D) High-dose steroids
Answer: A) Broad-spectrum antibiotics

In the Gustilo classification, what characterizes Type IIIB fractures?
A) Adequate soft tissue coverage
B) Severe soft tissue damage with exposure
C) Clean wound with minimal damage
D) Complicated by neurovascular injury
Answer: B) Severe soft tissue damage with exposure

What is the role of tetanus prophylaxis in open fractures?
A) To prevent infection
B) To reduce pain
C) To promote healing
D) To prevent tetanus infection
Answer: D) To prevent tetanus infection

Which imaging technique is most commonly used to evaluate open fractures?
A) X-ray
B) MRI
C) Ultrasound
D) CT scan
Answer: A) X-ray

What is the typical duration for antibiotic therapy in open fractures?
A) 24 hours
B) 48 hours
C) 3-5 days
D) 7-10 days
Answer: C) 3-5 days

What is a potential long-term complication of poorly managed open fractures?
A) Osteoarthritis
B) Osteoporosis
C) Fracture dislocation
D) Chronic pain
Answer: D) Chronic pain

What does the term ‘wound classification’ refer to in the context of open fractures?
A) The type of fracture
B) The extent of soft tissue damage
C) The patient’s age
D) The fracture’s healing time
Answer: B) The extent of soft tissue damage

Which factor is not included in the Gustilo classification?
A) Wound size
B) Vascular status
C) Bone exposure
D) Patient’s age
Answer: D) Patient’s age

What is the main goal of surgical intervention in open fractures?
A) To remove all foreign material
B) To achieve optimal healing
C) To restore function immediately
D) To prevent any complications
Answer: B) To achieve optimal healing

In the context of open fractures, what does the term ‘debridement’ refer to?
A) A type of fixation
B) The process of removing devitalized tissue
C) The surgical repair of bone
D) The application of antibiotics
Answer: B) The process of removing devitalized tissue

What is a key indicator of successful management of an open fracture?
A) Immediate pain relief
B) Radiological signs of union
C) No visible scarring
D) Normal range of motion
Answer: B) Radiological signs of union

What role do bone grafts play in managing open fractures?
A) They stabilize the fracture
B) They promote healing in non-unions
C) They replace lost tissue
D) They prevent infection
Answer: B) They promote healing in non-unions

Which type of fracture has the highest risk of infection?
A) Closed fracture
B) Open fracture
C) Stress fracture
D) Pathological fracture
Answer: B) Open fracture

What is the significance of the “Golden Hour” in trauma management?
A) The time for rehabilitation
B) The time frame for surgical intervention
C) The best time for diagnosis
D) The ideal time for imaging
Answer: B) The time frame for surgical intervention

Which of the following is a typical symptom of an open fracture?
A) Swelling and bruising
B) Numbness and tingling
C) Bone protruding through the skin
D) Fever and chills
Answer: C) Bone protruding through the skin

What should be done if a patient with an open fracture presents with signs of shock?
A) Delay treatment for imaging
B) Prioritize fluid resuscitation and stabilization
C) Only provide pain relief
D) Perform surgery immediately
Answer: B) Prioritize fluid resuscitation and stabilization

In open fracture management, why is early mobilization encouraged after surgery?
A) To prevent muscle atrophy
B) To promote fracture healing
C) To reduce pain
D) To facilitate rehabilitation
Answer: A) To prevent muscle atrophy

What is a common mistake in the management of open fractures?
A) Delaying surgery
B) Immediate irrigation
C) Administering antibiotics
D) Stabilizing the fracture
Answer: A) Delaying surgery

What is the most critical factor affecting the prognosis of an open fracture?
A) Type of fracture
B) Timing of treatment
C) Patient’s age
D) Location of the fracture
Answer: B) Timing of treatment

What is the ideal method for dressing an open fracture?
A) Tight bandage
B) Moist wound dressing
C) Dry gauze
D) No dressing
Answer: B) Moist wound dressing

What is a common misconception about open fractures?
A) They heal faster than closed fractures
B) They are always complicated by infection
C) They require immediate surgical intervention
D) They can often be managed conservatively
Answer: A) They heal faster than closed fractures

What should be monitored closely after the management of an open fracture?
A) Wound healing and signs of infection
B) Blood pressure only
C) Mobility of the limb
D) Nutritional status
Answer: A) Wound healing and signs of infection

What is the impact of soft tissue injury on the management of open fractures?
A) It has no impact
B) It determines the classification and treatment approach
C) It only affects recovery time
D) It makes the surgery easier
Answer: B) It determines the classification and treatment approach

What role does follow-up care play in the management of open fractures?
A) It is not necessary
B) It helps in monitoring healing and complications
C) It is only for psychological support
D) It is only for physical rehabilitation
Answer: B) It helps in monitoring healing and complications

 

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