A soft tissue injury is an injury caused by the use of force. Soft tissues include tissues that protect the bone and surrounding tissue, such as muscles, tendons, ligaments, skin, subcutaneous tissue, fatty tissue, including vascular and nerve tissue. Statistically, injuries to the Achilles tendon, patellar tendon or biceps tendon are the most common.
Soft-tissue injuries are generally divided into open and closed injuries. If there is still uninjured skin over the injury, it is a closed injury. If, on the other hand, the skin has already been injured, it is an open injury.
Classification according to Tscherne and Oestern
In order to better assess the extent of the injury, a classification of soft tissue injuries was developed, which distinguishes between open and closed injuries. Open soft tissue injuryThe open soft tissue injury can be divided into four grades: Closed soft tissue injuryThe difficulty with closed soft tissue injuries is that it is easy to overlook serious injuries or the extent of the injury is unclear at first.
- Grade 1: Grade 1 is a piercing of the skin from the inside to the outside.
- Grade 2: Grade 2 is a larger soft tissue injury, with violent impact from the inside out. Here the risk of inflammation is increased.
- Grade 3: Grade 3 is an exposed fracture with additional injuries to vessels and nerves.
- Grade 4: Amputation injury
- Grade 0: simple fracture injury, no or hardly any soft tissue injury through indirect force
- Grade 1: simple to moderate fracture injury with superficial skin injury or crushing by bone fragments
- Grade 2: moderately severe to severe fracture injury, it is a deep, often contaminated wound with skin abrasion, bruising by direct force and a dreaded compartment syndrome (in compartment syndrome there is an increase in pressure in the tissue, for example due to bleeding into the tissue. The pressure increase leads to a squeezing of the vessels and nerves and thus to a circulatory disorder and death of the tissue).
- Grade 3: Severe fracture injury with high skin crushing and/or injury to the musculature, dermal wounds (decollement: in this case upper skin layers are separated from deeper soft tissue layers by tangential force), compartment syndrome (see above) and vascular injuries