Tscherne et al developed a classification for limb fractures. This can help separate injuries into severity groups.
Parameters:
(1) status of overlying skin
(2) soft tissue injury
(3) fracture severity
(4) contamination, including site of accident
(5) amputation
Overlying Skin |
Major Subdivision |
closed |
C |
open |
O |
Severity of Soft Tissue Damage |
Fracture Severity |
Contamination |
Grade Closed Fracture |
none |
mild |
none |
0 |
mild |
mild to moderate |
none |
I |
moderate |
mild to severe |
none |
II |
severe |
mild to severe |
none |
III |
Severity Soft Tissue Damage |
Fracture Severity |
Contamina-tion |
Other |
Grade Open Fracture |
mild |
mild to moderate |
none to mild |
|
I |
moderate |
mild to severe |
moderate |
|
II |
severe |
mild to severe |
severe |
includes farm accidents |
III |
severe |
mild to severe |
mild to severe |
amputation, subtotal or total |
IV |
where:
• A grade IV open fracture involves separation of all important anatomic structures with total ischemia. If revascularized then considered grade III.
NOTE: There is no Grade 0 open fracture or Grade IV closed fracture.
Specialty: Surgery, orthopedic, Emergency Medicine, Critical Care, Surgery, general