Updated: 9/26/2013

Tscherne Classification

Review Topic
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
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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