Bolliger et al reported a score for determining the severity of crush injury and fractures following trauma. The authors are from the University of Bern.
Patient selection: trauma
Parameters:
(1) body region and crush injury
(2) maximum grade of crush injury
(3) body region and fracture
(4) fracture grade in each body region
Body regions for crush injury:
(1) head
(2) upper extremities
(3) ventral trunk
(4) dorsal trunk
(5) lower extremities
|
Any Crush Injury
|
Points
|
|
no
|
0
|
|
yes
|
1
|
The maximum crush injury is then determined.
|
Crush Injury
|
Grade
|
|
none
|
0
|
|
<= 20 square cm
|
1
|
|
21 to 70 square cm
|
2
|
|
> 70 square cm
|
3
|
where:
• A circular area of 20 square cm has a diameter of 5 cm.
• A circular area of 70 square cm has a diameter of 9.4 cm.
subscore for crush injury =
= SUM(number of regions with crush injury) * (maximum grade of crush injury)
Body regions for fracture grade:
(1) head and neck
(2) thorax
(3) abdomen and pelvis
(4) upper extremities
(5) lower extremities
Each body region is graded for fractures in the region.
|
Fracture
|
Points
|
|
none
|
0
|
|
isolated
|
1
|
|
multiple or comminuted
|
2
|
subscore for fractures =
= SUM(points for all 5 regions)
total score =
= (subscore for crush injury) + (subscore for fracture)
Interpretation:
• minimum score: 0
• maximum subscore for crush injury: 15
• maximum subscore for fracture: 10
• maximum total score: 25
