Johner and Wruhs used functional criteria to evaluate a patient's outcome following a tibial shaft fracture. This can help identify a patient who may require additional therapy. The authors are from the Hopital Cantonal in Fribourg and University Clinic for Orthopaedic Surgery in Bern, Switzerland.
Parameter:
(1) nonunion
(2) osteitis
(3) amputation
(4) neurovascular disturbance
(5) varus or valgus deformity
(6) anteversion or recurvation
(7) rotational deformity
(8) shortening
(9) knee mobility
(10) ankle mobility
(11) subtalar joint mobility
(12) pain
(13) gait
(14) ability to participate in strenuous activities
|
Parameter |
Finding |
Outcome |
|
nonunion |
absent |
excellent/good/fair |
|
|
present |
poor |
|
osteitis |
absent |
excellent/good/fair |
|
|
present |
poor |
|
amputation |
absent |
excellent/good/fair |
|
|
present |
poor |
|
neurovascular disturbance |
none |
excellent |
|
|
minimal |
good |
|
|
moderate |
fair |
|
|
severe |
poor |
|
varus or valgus deformity |
none |
excellent |
|
|
2 - 5° |
good |
|
|
6 - 10° |
fair |
|
|
> 10° |
poor |
|
anteversion or recurvation |
0 - 5° |
excellent |
|
|
6 - 10° |
good |
|
|
11 - 20° |
fair |
|
|
> 20° |
poor |
|
rotational deformity |
0 - 5° |
excellent |
|
|
6 - 10° |
good |
|
|
11 - 20° |
fair |
|
|
> 20° |
poor |
|
shortening |
0 - 5 mm |
excellent |
|
|
6 - 10 mm |
good |
|
|
11 - 20 mm |
fair |
|
|
> 20 mm |
poor |
|
knee mobility |
normal |
excellent |
|
|
> 80% |
good |
|
|
75 - 80% |
fair |
|
|
< 75% |
poor |
|
ankle mobility |
normal |
excellent |
|
|
> 75% |
good |
|
|
50 - 75% |
fair |
|
|
< 50% |
poor |
|
subtalar joint mobility |
> 75% |
excellent |
|
|
50 - 75% |
good |
|
|
< 50% |
fair |
|
pain |
none |
excellent |
|
|
occasional |
good |
|
|
moderate |
fair |
|
|
severe |
poor |
|
gait |
normal |
excellent/good |
|
|
normal |
good |
|
|
insignificant limp |
fair |
|
|
significant limp |
poor |
|
ability to perform strenuous activities |
possible |
excellent |
|
|
limited |
good |
|
|
SpecialtyInfoPurpose: To evaluate a patient's outcome after a tibial shaft fracture using the criteria of johner and Wruhs. Specialty: Surgery, orthopedic Objective: severity, prognosis, stage ICD-10: S82.2, |
