Trauma · Orthopaedics · Emergency Medicine

Bastion Classification of Lower Limb Blast Injuries calculator

Enter the published formula inputs below to calculate and interpret this score.

Clinical inputs

Most proximal level of injury

Choose the highest level the injury reaches on the limb. Any buttock involvement is class 5.

Result

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Primary source

Jacobs N, Rourke K, Rutherford J, Hicks A, Smith SRC, Templeton P, Adams SA, Jansen JO. Lower limb injuries caused by improvised explosive devices: proposed 'Bastion classification' and prospective validation. Injury. 2014;45(9):1422-1428. DOI: 10.1016/j.injury.2012.05.001. PMID: 22613453. Class definitions as reproduced in Appendix C of the US Joint Trauma System Clinical Practice Guideline 28 (Invasive Fungal Infection in War Wounds). The class is set by the most proximal extent of injury: class 1 injury confined to the foot; class 2 injury involving the lower leg, permitting effective below-knee tourniquet application; class 3 injury involving the proximal lower leg or thigh, permitting effective above-knee tourniquet application; class 4 proximal thigh injury preventing effective tourniquet application; class 5 any injury involving the buttock. (2014)

Scope: Lower limb injuries from improvised explosive devices, graded by the most proximal level of injury. It does not include the associated-injury subgroups of the original paper and does not grade soft tissue or bone damage.

Last reviewed 2026-10-18

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Professional use only

For qualified clinicians. Independently verify inputs, calculations, source guidance, and applicability before any clinical action. This calculator does not replace clinical judgment.

Source: Jacobs N, Rourke K, Rutherford J, Hicks A, Smith SRC, Templeton P, Adams SA, Jansen JO. Lower limb injuries caused by improvised explosive devices: proposed 'Bastion classification' and prospective validation. Injury. 2014;45(9):1422-1428. DOI: 10.1016/j.injury.2012.05.001. PMID: 22613453. Class definitions as reproduced in Appendix C of the US Joint Trauma System Clinical Practice Guideline 28 (Invasive Fungal Infection in War Wounds). The class is set by the most proximal extent of injury: class 1 injury confined to the foot; class 2 injury involving the lower leg, permitting effective below-knee tourniquet application; class 3 injury involving the proximal lower leg or thigh, permitting effective above-knee tourniquet application; class 4 proximal thigh injury preventing effective tourniquet application; class 5 any injury involving the buttock. (2014)

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Clinical inputs

Most proximal level of injury

Primary source

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