Updated: 5/27/2021

Tscherne Classification

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  • Closed Fractures
    • The Oestern and Tscherne classification for closed fractures
    • Oestern and Tscherne classification of soft tissue injury in closed fractures
      Grade 0


      • Minimal soft tissue damage
      • Indirect injury to limb (torsion)
      • Simple fracture pattern
      Grade 1

      • Superficial abrasion or contusion
      • Mild fracture pattern
      Grade 2



      • Deep abrasion
      • Skin or muscle contusion
      • Severe fracture pattern
      • Direct trauma to limb
      Grade 3



      • Extensive skin contusion or crush injury
      • Severe damage to underlying muscle
      • Compartment syndrome
      • Subcutaneous avulsion
  • Open Fractures
    • The Oestern and Tscherne classification for open fractures
      • uses wound size, level of contamination, and fracture pattern to grade open fractures
    • The Oestern and Tscherne classification for open fractures
      Grade I


      • Open fractures with a small puncture wound without skin contusion
      • Negligible bacterial contamination
      • Low-energy fracture pattern
      Grade II


      • Open injuries with small skin and soft tissue contusions
      • Moderate contamination
      • Variable fracture patterns
      Grade III


      • Open fractures with heavy contamination
      • Extensive soft tissue damage
      • Often, associated arterial or neural injuries
      Grade IV
      • Open fractures with incomplete or complete amputations

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