Predictive salvage index

Artery

Supra popliteal level1

Popliteal level2

Infra popliteal level3

Bone

Mild1

Moderate2

Severe3

Muscle

Mild1

Moderate2

Severe3

Interval up to operating theatre

12 hours3

From:Indian J Orthop. 2008 OctDec; 42(4): 368376. Doi : 10.4103/0019-5413.43371. Copyright Indian Journal of Orthopaedics

Nerve injury, ischemia, soft tissue injury, skeletal injury shock & age of patient score (NISSA)

Nerve

SensateNo major nerve injury1

DorsalDeep peroneal nerve2

Plantar partialTibial nerve injury3

Plantar completeSciatic nerve4

Ischemia

NoneGood to fair pulses, no ischemia0

MildDecreased pulses perfusion1

ModerateProlonged capillary refill, Doppler pulses fill2

SeverePulseless, cool, ischemic, no doppler3

Soft Tissue

Grade IMinimal contamination0

Grade IIModerate soft tissue injury, low velocity1

Grade IIIAModerate crush injury, high velocity with Considerable contamination2

Grade IIIBMassive crush injury severe contamination3

Skeletal

Spiral or oblique fracture0

Transverse fracture-minimal contamination1

Moderate displacement and communition with high velocity2

Segmental fracture, severe communition, bony loss3

Shock

Normotensive0

Transient hypotensive1

Persistent hypotensive2

If ischemia time more than six hours, add 2 pointsFrom: Indian J Orthop. 2008 OctDec; 42(4): 368376. doi: 10.4103/0019-5413.43371. Copyright Indian Journal of OrthopaedicsLimb salvage index

Artery

Contusion, intimal tear, partial laceration0

Occlusion of two or more shank vessels, no pedal pulses felt1

Complete occlusion of femoral or three shank vessels2

Nerve

Contusions, stretch, minimal laceration0

Partial transaction or avulsion of sciatic nerve1

Complete transaction or avulsion of sciatic nerve2

Bone

Closed or open fracture with minimum communition0

Closed fracture at two or more sites at same limb;1

Open fracture with communition or moderate to large displacement with bone loss < 5 cm

Bone loss more than 5 cm Grade IIIB or IIIC2

Skin

Clean injury, primary repair, first degree burn0

Delayed closure due to contamination requiring skin graft or flap, second or third degree burn1

Musculotendinous unit

Laceration or avulsion involving the single compartment or tendon0

Complete avulsion injury involving two or more tendon1

Deep Vein

Contusion, partial laceration0

Complete laceration, avulsion or thrombosis1

Warm ischemia

Less than six hours0

6-9 hours1

9-12 hours2

12-15 hours3

More than 15 hours4

From:Indian J Orthop. 2008 OctDec; 42(4): 368376. doi: 10.4103/0019-5413.43371. Copyright Indian Journal of Orthopaedics