Description

The Hannover Fracture Scale '98 is an update to the Hannover Fracture Scale that was developed in 1983. It is a simpler instrument yet reliable measure of limb salvage. The authors are from Medizinische Hochschule Hannover.


Parameters:

(1) extent of fracture bone loss

(2) skin injury as percent of limb circumference

(3) muscle injury as percent of limb circumference

(4) wound contamination

(5) deperiostation

(6) local circulation

(7) systolic blood pressure (systemic circulation)

(8) neurologic findings

 

Parameter

Finding

Points

extent of bone loss

none

0

 

0.1 to 1.9 cm

1

 

>= 2.0 cm

2

skin injury

none

0

 

1 - 24% of circumference

1

 

25 - 50% of circumference

2

 

51 - 75% of circumference

3

 

76 - 100% of circumference

4

muscle injury

none

0

 

1 - 24% of circumference

1

 

25 - 50% of circumference

2

 

51 - 75% of circumference

3

 

76 - 100% of circumference

4

wound contamination

none

0

 

partial

1

 

massive

2

deperiostation

no

0

 

yes

1

local circulation

normal

0

 

capillary pulse

1

 

ischemia < 4 hours

2

 

ischemia 4 to 8 hours

3

 

ischemia > 8 hours

4

systolic blood pressure

constantly > 100 mm Hg

0

 

< 100 until admission

1

 

< 100 until surgery

2

 

constantly < 100 mm Hg

3

palmar-plantar sensibility

yes

0

 

no

1

finger-toe active motion

yes

0

 

no

1

 

total score =

= SUM(points for all 8 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 22

• The higher the score the worse the injury.

• A score >= 11 indicates significant trauma, with amputation recommended.

 

Performance:

• The sensitivity was 82% and specificity 99%.


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