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Deep Infection Following Open Fracture of an Extremity | Prediction Risk Score

Purpose: To identify a patient with an open fracture of an extremity who is at risk for deep infection using the score of Yokoyama et al based on the HFS '98.

Description

Yokoyama et al propsed a scoring system for predicting deep infection associated with an open fracture involving an upper or lower extremity. It is based on 3 of 9 factors from the Hannover Fracture Scale '98. The authors are from Machida Municipal Hospital and Kitasato University in Japan.


NOTE: The authors also developed a score for tibial fractures.

 

Parameters and scoring from the Hannover Fracture Scale '98 (HFS '98):

(1) muscle injury

(2) wound contamination

(3) local circulation

 

Parameter

Finding

Points

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

local circulation

normal

0

 

capillary pulse

1

 

ischemia < 4 hours

2

 

ischemia 4 to 8 hours

3

 

ischemia > 8 hours

4

 

score =

= (5 * (HFS points for muscle injury)) + (5 * (HFS points for local circulation)) + (10 * (HFS points for wound contamination))

 

Interpretation:

• minimum score: 0

• maximum score: 60

• A score >= 35 was associated with deep infection.

• According to Figure 1 a score >= 25 identifies an indeterminate group.


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Specialty

Objective

ICD-10