Review Article
Management of Major Limb Injuries
Table 2
Ganga hospital open injury severity score.
| | Covering structures: Skin and fascia | Score |
| | Wounds without skin loss | | | Not over the fracture | 1 | | Exposing the fracture | 2 | | Wounds with skin loss | | | Not over the fracture | 3 | | Over the fracture | 4 | | Circumferential wound with skin loss | 5 | | Skeletal structures: Bone and joints | | | Transverse/oblique fracture/butterfly fragment < 50% circumference | 1 | | Large butterfly fragment > 50% circumference | 2 | | Comminution/segmental fractures without bone loss | 3 | | Bone loss < 4 cm | 4 | | Bone loss > 4 cm | 5 | | Functional tissues: musculotendinous (MT) and nerve units | | | Partial injury to MT unit | 1 | | Complete but repairable injury to MT units | 2 | | Irreparable injury to MT units/partial loss of a compartment/complete injury to posterior tibial nerve | 3 | | Loss of one compartment of MT units | 4 | | Loss of two or more compartments/subtotal amputation | 5 | | Comorbid conditions: add 2 points for each condition present | | | Injury-debridement interval > 12 hrs | | | Sewage or organic contamination/farmyard injuries | | | Age > 65 yrs | | | Drug-dependent diabetes mellitus/cardio respiratory diseases leading to increased anesthetic risk | | | Polytrauma involving chest or abdomen with ISS > 25/Fat embolism | | | Hypotension with systolic blood pressure < 90 mm Hg at presentation | | | Another major injury to the same limb/compartment syndrome | |
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