Neer et al developed criteria for evaluating outcome for a patient after a supracondylar fracture of the femur. The authors are from Columbia University, Columbia-Presbyterian Medical Center and Harlam Hospital Center in New York City.
Groups:
(1) functional (70 points): pain, function, motion, work
(2) anatomic (30 points): gross anatomy, roentgenogram
Parameters:
(1) pain (20 points)
(2) function (20 points)
(3) range of motion (20 points)
(4) ability to work (10 points)
(5) gross anatomy (15 points)
(6) roentgenogram (15 points)
|
Parameters |
Finding |
Points |
|
pain |
no pain |
20 |
|
|
intermittent, or with bad weather |
16 |
|
|
with fatigue |
12 |
|
|
restrict function |
8 |
|
|
constant or at night |
4 |
|
|
extreme |
0 |
|
function (mobility) |
as before injury |
20 |
|
|
mild restriction |
16 |
|
|
restricted; climb stairs sideways |
12 |
|
|
cane or severe restriction |
8 |
|
|
crutches or brace |
4 |
|
|
totally disabled |
0 |
|
range of motion in knee |
normal or >= 135 degrees |
20 |
|
|
100 degrees |
16 |
|
|
80 degrees |
12 |
|
|
60 degrees |
8 |
|
|
40 degrees |
4 |
|
|
<= 20 degrees |
0 |
|
work |
as before injury |
10 |
|
|
regular but with handicap |
8 |
|
|
regular but with change |
6 |
|
|
light work |
4 |
|
|
minimal work |
2 |
|
|
totally disabled |
0 |
|
gross anatomy |
thickening only |
15 |
|
|
5 degrees angulation or 0.5 cm short |
12 |
|
|
10 degrees angulation or 2.0 cm short |
9 |
|
|
15 degrees angulation or 3.0 cm short |
6 |
|
|
union but with greater deformity |
3 |
|
|
non-union or chronic infection |
0 |
|
roentgenogram |
normal or near normal |
15 |
|
|
5 degrees angulation or 0.5 cm displacement |
12 |
|
|
10 degrees angulation or 1.0 cm displacement |
9 |
|
|
15 degrees angulation or 2.0 cm displacement |
6 |
|
|
union but with greater deformity; spreading of condyles; osteo-arthritis |
3 |
|
|
non-union or chronic infection |
0 |
where:
• In the original table pain and functional levels the most severely affected states were designated as "4 - 0" points.
• It is tempting to assign 2 points for a range of motion from 21 to 39 degrees.
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 100
• The higher the total score, the greater the function.
|
Total Score |
Outcome Assessment |
|
> 85 |
excellent |
|
70 - 85 |
satisfactory |
|
55 - 69 |
unsatisfactory |
|
< 55 |
failure |
where:
• One possible modification would be to make 86-95 good and > 95 excellent.
Specialty: Surgery, orthopedic
