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Zhu Tongbo classifies open fractures into three degrees based on wound size, severity of soft tissue damage, degree of contamination, and exposure of the fracture ends.
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| Grade I Open Fracture | The skin is pierced from the inside out by the fracture end, the wound is less than 3 cm, soft tissue contusion is mild, and there is no significant contamination or exposure of the fracture ends. |
| Grade II Open Fracture | The wound is 3-15 cm long, the fracture ends are exposed, there is moderate soft tissue damage, and significant contamination. |
| Grade III Open Fracture | The wound is more than 15 cm long, the fracture ends are exposed, there is severe soft tissue damage, often accompanied by nerve and vascular injuries, and severe contamination. |
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