classification -the need to modernise IntroductionIt is well known that the clinical outcome of open fractures is, in part, dependent on the injury severity and specifically on the extent of any soft tissue disruption. In order to collect meaningful data, and to offer guidance that is easy to follow, there must be reproducible means of classifying these injuries. With a robust classification system, there should come a sensible management algorithm that is user friendly and not open to misinterpretation. Accuracy of such data supports meaningful research and allows evolution in fracture care. Currently, the most commonly (mis)quoted classification system for open fractures is that of Gustilo and Anderson 1 2 . However, there has been some loss in translation from the original articles 3 . Furthermore, the original Gustilo-Anderson system has several limitations when applied to open fracture management in the current clinical era.Many healthcare systems around the world have algorithms and recommendations for treatment of open fractures. These serve to help achieve predictable outcomes for patients and to set standards against which performance can be measured, often with financial incentives. These algorithms suggest management strategies dependent on the grade of the open fracture as defined in the original Gustilo-Anderson classification.Here, we challenge the validity of the original grading systems and discuss the concept of an ideal system, based on patient reported outcomes and resource consumption in the 21 st century.