A 30-year-old man has a closed tibial shaft fracture from a motorcycle crash. The limb shows marked swelling, tension vesicles over the anteromedial leg, and patchy ecchymosis. There is no degloving and compartment pressures are normal. According to the Tscherne classification of closed soft tissue injuries, this is:

• A Grade 0
• B Grade I
• C Grade III
• D Grade II ✓

Explanation

Tscherne grading for closed fractures: Grade 0 has minimal soft tissue damage from indirect injury; Grade I has superficial abrasions or contusions from fragment pressure; Grade II features deep contaminated abrasions with impending compartment syndrome, marked swelling, and blisters; Grade III involves extensive contusion or crushing with degloving or established compartment syndrome, often in severe crush injuries. Blisters plus marked swelling without degloving place this patient squarely at Grade II.

Reference: Rockwood and Green's Fractures in Adults, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.