by AceMedEd

Teach card · keep it in your scrub pocket

Open fracture

Ask after the case (five minutes)

  1. On the debrided wound: "Now that you've seen it debrided, what Gustilo–Anderson type is this, and what would have made it one type higher?"
  2. On the leg: "Show me the skin-only surface of the tibia. If this wound had left bone bare, which muscle is near it at this level, and why is the distal third harder?"
  3. On the trauma-bay notes: "Walk me through what was done before we came to the OR, then tell me the pulse and nerve exam you would document, by territory."

Point at: the edge of the debrided wound, while they say whether the bone is covered and what that makes the type.

End of day: "Draw me the mid-leg slice with the skin-only surface of the tibia, then the five Gustilo–Anderson types." Two minutes, no notes.

Where this kit and your technique differ, yours wins.

Send this to your students

Send it now. They prep alone while they wait, you stay with the patient, and you debrief for five minutes after the case. They won't see these questions.

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Reviewed by Mehdi “AC” Talle, D.O., November 2026. Sources: Netter, Gray's Anatomy and Hoppenfeld's surgical exposures, with Rockwood and Green for fractures. Teaching schematic, not to scale; anatomy and technique vary. Management and indications are left to you on purpose.