|
Year |
2002 |
|---|---|
|
Question Number |
45 |
|
Category |
Musculoskeletal Trauma |
Question
A patient with an isolated femur fracture has an ISS of 9. A patient with bilateral femur fractures and no other injuries has an ISS of
1- 9.
2- 16.
3- 18.
4- 25.
5- 81.
Figures
Answer (click for answer)
Preferred Answer 1
The Injury Severity Score is used to provide researchers control of the variability of trauma severity for evaluating outcomes. The ISS uses individual scores for the three most severely injured anatomic areas for a patient, but only considers the highest score from any single anatomic site. So a second skeletal injury does not change the ISS. However a retrospective study of 800 unilateral and 85 bilateral femur fractures from blunt trauma showed that mortality was significantly higher in patients with bilateral (25.9) versus unilateral (11.7) femur fractures and that the ISS was significantly higher in patients with bilateral femur fractures (from associated injuries). Attempts to demonstrate a significant difference in mortality in bilateral versus unilateral femur fractures while controlling for ISS was equivocal.
Reference: Koval, KJ (ed): Orthopaedic Knowledge Update 7 pp 111-120. and Copeland et al.: Mortality in patients with bilateral femoral fractures. J Orthop Trauma 1998; 12:315-319.