Rajasekaran and Raja Sabapathy reported the Ganga Hospital Score (GHS) for evaluating open trauma to an extremity. The goal was to develop a score that can help to guide management and to predict functional outcome. The authors are from Ganga Hospital in TamilNadu, India.
Parameters:
(1) injury to skin and fascia (covering structures)
(2) injury to bone and joints (skeletal structures)
(3) injury to musculotendinous and nerve units (functional tissue)
(4) comorbid conditions
|
Parameter |
Finding |
Points |
|---|---|---|
|
injury to skin and fascia |
none |
0 |
|
|
wound without skin loss not over fracture |
1 |
|
|
wound without skin loss over the fracture |
2 |
|
|
wound with skin loss not over the fracture |
3 |
|
|
wound with skin los over the fracture |
4 |
|
|
circumferential wound with skin loss |
5 |
|
injury to bone and joints |
none |
0 |
|
|
transverse, oblique or small butterfly fragment (< 50% of circumference) |
1 |
|
|
large butterfly fragment (>= 50% of circumference) |
2 |
|
|
comminution or segmental fracture without bone loss |
3 |
|
|
fracture with bone loss < 4 cm |
4 |
|
|
fracture with bone loss >= 4 ccm |
5 |
|
injury to musculotendinous and nerve units |
none |
0 |
|
|
partial injury to unit |
1 |
|
|
complete but repairable |
2 |
|
|
complete and unrepairable |
3 |
|
|
loss of one compartment |
4 |
|
|
loss of two or more compartments |
5 |
|
|
subtotal amputation |
5 |
where:
• A score of 1 or 2 points indicates an injury that can be managed without any special secondary procedure. A score of 3 indicates that a special secondary procedure is needed with expectation of good functional outcome. A score of 4 or 5 indicates a serious, complex injury which may have a poor functional outcome despite optimum care.
Comorbid conditions - 2 points for each of the following:
(1) > 12 hours interval between injury and debridement
(2) age > 65 years
(3) contamination of the wound with sewage, organic material, farmyard, etc
(4) systolic blood pressure < 90 mm Hg at presentation (hypotension)
(5) compartment syndrome or another major injury to the same limb
(6) increased risk anesthesia due to drug-dependent diabetes mellitus or cardiorespiratory diseases
(7) polytrauma involving chest and abdomen with ISS > 25 and/or fat embolism
Ganga Hospital Score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 29
• The higher the score the more severe the trauma.
• A score >= 14 was used as the threshold score for amputation.
Purpose: To evaluate a patient with significant trauma to an extremity with an open injury using the Ganga Hospital Score (GHS).
Specialty: Surgery, orthopedic, Emergency Medicine, Critical Care, Surgery, general
Objective: severity, prognosis, stage
ICD-10: T02,
