Classification of Tscherne for Fractures

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

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.

To read more or access our algorithms and calculators, please log in or register.