Kraft et al evaluated radiographic changes associated with osteomyelitis involving metal plates placed on tibial fractures. Although the score was used in a rabbit model the score can be used in patients. The authors are from the University of Bonn, the University of Bern, the AO/ASIF Research Institute and BG-Unfallklinik Bergmannsheil.
Parameters:
(1) sequestral bone formation
(2) periosteal new bone formation
(3) destruction of bone
(4) loosening of the screw and/or plate (hardware)
(5) reaction about the implant
(6) calcification in soft tissues
(7) soft tissue swelling
|
Parameter |
Finding |
Points |
|
sequestral bone formation |
absent |
0 |
|
|
present |
1 |
|
periosteal new bone formation |
absent |
0 |
|
|
indeterminate |
0.5 |
|
|
present |
1 |
|
bone destruction |
none |
0 |
|
|
mild with only 1 area involved |
0.5 |
|
|
moderate |
1 |
|
|
severe with multiple areas |
2 |
|
loosening of the hardware |
none |
0 |
|
|
mild with only 1 area involved |
0.5 |
|
|
moderate |
1 |
|
|
severe with multiple areas |
2 |
|
reaction about the implant |
none |
0 |
|
|
mild with only 1 area involved |
0.5 |
|
|
moderate |
1 |
|
|
severe with multiple areas |
2 |
|
calcification in soft tissues |
none |
0 |
|
|
indeterminate |
0.5 |
|
|
present |
1 |
|
soft tissue swelling |
none |
0 |
|
|
indeterminate |
0.5 |
|
|
present |
1 |
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• The higher the score the greater the probability of significant osteomyelitis.
• A score >= 2 indicates a greater risk for bacterial osteomyelitis.
• A periosteal reaction was an early finding seen with osteomyelitis.
Specialty: Infectious Diseases, Surgery, orthopedic
ICD-10: ,
