Validity of vetrivel trauma score in predicting salvage of limb in gustilo anderson grade III B and grade III C open fractures

Abstract

There have been many classification systems developed for open fractures like Gustilo Anderson grading system, Mangled extremity severity score, Ganga hospital open injury severity score. But the gray zone still exists in many open fractures whether the limb has to be salvaged or amputated. The above-mentioned scores have poor sensitivity and specificity in evaluating open fractures. This led to the development of a novel scoring system known as Vetrivel trauma score.This study aims to assess the validity of this novel scoring system in predicting the outcome of limbs in Gustilo Anderson Grade IIIB and Grade IIIC open fractures.One hundred and forty-four open fracture cases were taken for this study. 82 patients sustained Grade III injuries according to the Gustilo Anderson classification. Of these, 35 patients were of Grade IIIB and above. These 35 patients were scored using Vetrivel Trauma score, Ganga hospital open injury severity score, and Mangled extremity severity score.Vetrivel trauma score was compared with Ganga hospital open injury severity score, and Mangled extremity severity score. Analysis indicated Vetrivel trauma scoring system is more accurate than others. The area under the curve of the receiver operating characteristic curve for Vetrivel Trauma score (0.983) is found to be significantly higher than other scoring systems compared.Vetrivel trauma score is a better predictor of injury severity in Grade IIIB and Grade IIIC open fractures with the highest sensitivity and specificity in deciding amputation versus salvage. A score of 39 or more has the highest predictability for amputation.