Description

Yokoyama et al developed a simple score for identifying a patient with an open tibial fracture who is at risk for developing a deep infection. A patient at risk may benefit from closer monitoring and more aggressive management. The authors are from Machida Municipal Hospital and Kitasato University in Japan.


Patient selection: open tibial fracture

 

Parameters:

(1) extent of bone loss

(2) extent of muscle injury

(3) extent of wound contamination

(4) blood supply

 

Parameter

Finding

Points

extent of bone loss

none

0

 

<= 2 cm

10

 

> 2 cm

20

muscle injury

none

0

 

< 25% of circumference

5

 

25 - 50% of circumference

10

 

51-75% of circumference

15

 

76 - 100% of circumference

20

wound contamination

none

0

 

some

15

 

marked/massive

30

blood supply

normal pulse

0

 

capillary pulse only

10

 

ischemia <= 4 hours

20

 

ischemia > 4 hours

30

 

total score =

= SUM(points for all 4 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 100

• A score >= 60 was associated with an increased risk of deep infection.

 

Performance:

• The ROC curve is shown in Figure 2 (page 111) but the AUC is not given.


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