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.
Purpose: To identify a patient with an open tibial fracture who is at risk for a deep infection using the score of Yokoyama et al.
Specialty: Infectious Diseases, Surgery, orthopedic, Surgery, general, Emergency Medicine
Objective: risk factors, severity, prognosis, stage
ICD-10: S82, T84.1, T79.3,