Trauma and burns: open fracture management: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Trauma and burns: open fracture management

Sample item

A farmer has an open tibial fracture with a 12 cm wound, extensive soft tissue damage and a contaminated field. Distal pulses are intact. Which Gustilo-Anderson type and management apply?

AType III; IV antibiotics within 1 hour, early debridement, and stabilisation with soft tissue coverBType IIIC; amputation alwaysCType II; delayed wound closure after 1 week onlyDType I; oral antibiotics and cast

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Type III; IV antibiotics within 1 hour, early debridement, and stabilisation with soft tissue cover

Type I wounds are under 1 cm, II are 1 to 10 cm without extensive damage, and III have extensive soft tissue injury or more than 10 cm (IIIA adequate cover, IIIB needs flap, IIIC with arterial injury needing repair). Antibiotics within 1 hour, tetanus prophylaxis, thorough debridement and early skeletal stabilisation are essential.

Option by option

A. Type III; IV antibiotics within 1 hour, early debridement, and stabilisation with soft tissue cover (correct)
Correct. Type III needs urgent antibiotics and debridement.
B. Type IIIC; amputation always
Pulses are intact, so this is not IIIC.
C. Type II; delayed wound closure after 1 week only
Type II is under 10 cm without extensive injury.
D. Type I; oral antibiotics and cast
Type I is a small clean wound.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Type III; IV antibiotics within 1 hour, early debridement, and stabilisation with soft tissue cover. Type I wounds are under 1 cm, II are 1 to 10 cm without extensive damage, and III have extensive soft tissue injury or more than 10 cm (IIIA adequate cover, IIIB needs flap, IIIC with arterial injury needing repair).

Why is "Type IIIC; amputation always" not the answer?

Pulses are intact, so this is not IIIC.

Why is "Type II; delayed wound closure after 1 week only" not the answer?

Type II is under 10 cm without extensive injury.

Why is "Type I; oral antibiotics and cast" not the answer?

Type I is a small clean wound.

What concept does this question test?

It tests Trauma and burns: open fracture management in General Surgery. Antibiotics within 1 hour, tetanus prophylaxis, thorough debridement and early skeletal stabilisation are essential.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Trauma and burns: open fracture management?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.