Score nach Phillips et al.

Anwendung

Sprunggelenksfrakturen
Anmerkung
Dieser Score wird zur Benutzung empfohlen: Dt. Ges. f. Orthopädie und Traumatologie + Berufsverb. d. Ärzte f. Orthopädie (Hrsg.) Leitlinien der Orthopädie. Dt. Ärzte-Verlag, Köln, 1999, S. 107ff oder www.awmf-online.de

A. Clinical Score
(total score 100 points)
  
Subjective (80 points)  
Pain (54 points) Always after any activity 0
  Prolonged after mild activity 10
 Transient after mild activity 20
 Prolonged after heavy activity 35
 Transient after heavy activity 40
 None 50
 Requires medication for pain regularly 0
 Requires medication occasionally 2
 Requires no medication 4
Function (26 points) Unable to climb stairs 0
  Uses normal foot first 1
 Requires aid of banister 2
 Climbs normally 3
 Unable to descend stairs 0
 Uses normal foot first 1
 Requires aid of banister 2
 Descends normally 3
 Walks < 1 block 0
 Walks < 5 blocks 2
 Walks < 10 blocks 3
 Walks > 10 blocks 5
 Walks unlimited distances 6
 Recreational activities limited 0
 No activities limited 3
 Requires walker 0
 Requires crutches 1
 Requires one crutch 2
 Requires cane 4
 Requires no aids 8
 Dissatisfied 0
 Moderately satisfied 2
 Very satisfied 3
Gait Antalgic limp 0
 External rotation gait 3
 Normal gait 6
Range of motion: difference from normal side Dorsiflexion  
  Difference > 20° 0
  Difference > 10° to 20° 2
  Difference < 10° 4
  No difference 7
 Plantar flexion  
 Difference > 20° 0
 Difference < 20° 2
 No difference 3
Supination Difference > 0° 0
 No difference 2
Pronation Difference > 0° 0
 No difference 2
    
B: Anatomical score  
Measurement [1]Acceptable values [2]pts.
Talocrural angle: difference from normal ≤5° 6
Medial clear space ≤4 mm 6
Integrity of tibiofibular syndesmosis Both indicators normal 6
Medial malleolar displacement ≤2 mm 6
Size of posterior malleolar fragment < 25% 6
Lateral malleolar displacement ≤2mm 1
Lateral malleolar shortening
compared with normal side
≤2 mm 1
Talar tilt ≤2mm 1
Talar subluxation Absent 1
Anteromedial corner -
continuity of articular surface
Present 1
   
C. Arthritis grading system
(points substracted from maximum)
  
No radiographics changes  0
Abnormalities (non-union, synostosis,
osteoporosis, irregular articular surface)
One abnormality 1
 Two or more abnormalities 3
Degenerative changes Mild 6
 Moderate 9
 Severe 12
   
 
[1] bitte die Definitionen in der Literatur nachschlagen
[2] für nicht akzeptable Werte wurden 0 Punkte vergeben