Tscherne classification
# Tscherne classification

The Tscherne classification is a system of categorization of soft tissue injuries.

## Classification

| Tscherne Grade | Open soft tissue injuries | Closed fractures |
| - | - | - |
| 0 | | Fr. C 0 - No or minor soft-tissue injury from a simple fracture due to indirect trauma |
| I | Fr. O 1 - Skin lacerated by bone fragment. No or minimal contusion to the skin | Fr. C 1 - Superficial contusion or abrasion to the skin |
| II | Fr. O 2 - Skin laceration with circumferential skin or soft-tissue contusion and moderate contamination | Fr. C 2 - Deep contaminated abrasions with skin or muscle contusion from direct trauma |
| III | Fr. O 3 - Extensive soft-tissue damage with major vessel or nerve injury | Fr. C 3 - Extensive skin contusion with destruction of subcutaneous tissue avulsion or muscle destruction |
| IV | Fr. O 4 - Subtotal and total amputations with separation of all important anatomical structures | |

## Reliability

The intraobserver (observations at two different times by the same person) agreement for Tscherne classification is 85%; while for inter-observer agreement is 65%.

## History

This classification system was developed by Harald Tscherne and Hans-Jörg Oestern in 1982 at the Hannover Medical School (Hanover, Germany) to classify both open and closed fractures. This classification system is based on the physiological concept that the higher the kinetic energy imparted on the bone, the higher the kinetic energy imparted on the soft tissue. It also serves as a tool to guide management and to predict clinical outcomes. It also serves as a communication tool in research and in clinical presentations.

