Download Common Fracture classifications

Peggers’ Super Summaries: Common Fracture classifications
Lower Limb:
PERIPROSTHETIC FRACTURE:
HIP
Vancouver 1995 (American academy of Orthopaedic Surgeons)
Type
Pattern
A GT
GT fracture
A LT
LT Fracture
B
Around or just distal to tip of
prosthesis
C
Below stem
KNEE FEMORAL COMPONENT
Lewis 1997 (Baltimore: Revision Total knee arthroplasty)
Type
Pattern
I
Undisplaced supracondylar
II
Displaced supracondylar
III
Loose prosthesis +
supracondylar
TIBIAL KNEE COMPONENT
Felix 1997 (Clinical Orthopaedics)
Subtype A – well fixed implant
Subtype B – Loose implant
Type
Pattern
I
Tibial plateau
II
Adjacent to stem
III
Distal to stem
IV
Tibial Tuberosity
PELVIS
Young Burgess 1990
Type
LC
I
II
APC
I
II
III
VS
CM
ANKLE
Weber
Type
A
B
C
Lauge Hansen (Lippincott: Rockwood & Green’s fractures in adults)
Type
Pattern
Supination ER
Spiral fibula +/- transverse
MM
Supination Adduction
Transverse Fibula +/- vertical
MM
Pronation ER
Transverse MM +/Transverse fibula
Pronation Adduction
Transverse MM +/Comminuted fibula
CALCANEAL FRACTURES

Bohler angle – posterior angle abnormal <20-40o

Gissane angle – v angle abnormal >105o
Sanders (CT scan classification) 2000 (JBJS Am)
Type
Pattern
I
Non displaced
II
2 part #
III
3 part #
IV
4 part / comminuted
A – Lateral 1/3
B – Middle 1/3
C – Medial 1/3
Pattern
lateral compression
Sacral compression
Iliac wing compression
AP Compression
Pubic Symphasis
SIJ widening
Displaced SIJ
Vertical shear
Combination
SUBTROCHANTERIC
Russell-Taylor 2006 (Lippincott: Rockwood & Green’s fractures in
adults)
Type
Pattern
I
Undisplaced
II
2 part
III
3 part fracture
IV
4 part or comminuted
V
Extension into GT
TIBIAL PLATEAU - “Divide and Conquer”
Schatzker 2006 (Lippincott: Rockwood & Green’s fractures in adults)
Type
Pattern
I
Lateral split
II
Lateral split and compression
III
Lateral compression
IV
Medial plateau
V
Both plateau
VI
Both plateau + metaphyseal #
Pattern
Below syndesmosis
Level Syndesmosis
Above Syndesmosis
viewing from behind
5TH METATARSAL FRACTURES

Zone 1 – peroneus brevis avulsion

Zone 2 – metaphyseal-diaphyseal junction ie Jones fracture

Zone 3 – diaphyseal stress fractures
Upper Limb:
CLAVICLE FRACTURES
Allman – anatomical description

Group 1 – middle 1/3 80% of #

Group 2 – distal 1/3 15% of #
o
Type 1 – minimal displacement
o
Type 2A displacement – both conoid and trapezoid
attached to distal segment
o
Type 2B displacement – only trapezoid attached
o
Type 3 – intra-articular ACJ #

Group 3 - proximal 1/3 5% of #
o
Type 1 – undisplaced
o
Type 2 – displaced
o
Type 3 – intra-articular
o
Type 4 – epiphyseal separation
o
Type 5 - comminuted
ACJ

Type 1 – sprain to ACJ palpation pain good shoulder ROM

Type 2 – distal clavicle superior to acromion

Type 3 – stress radiographs demonstrate 25-100% widening
when compared to normal side

Type 4 – posterior displacement of distal clavicle

Type 5 – 100-300% displacement superiorly of distal clavicle

Type 6 – Inferior dislocation
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Peggers’ Super Summaries: Common Fracture classifications
NB repair grade 4 and above or grade 3 in active young or labourers
NB trochlea of the humerus articulates with the ulna. Capitellum
articulates with the radius.
SHOULDER DISLOCATIONS

Bankart – labral tear

Bony Bankart – fracture of glenoid

Hill-sachs head compression defect
o
¼ of acute anterior dislocations
o
¾ of recurrent disolcations
The coronoid is the distal lip of the ulna articulation ie opposite the
olecranon.
OLECRANON FRACTURES
Mayo classification
A = non comminute
B = comminuted

Type 1 – undisplaced

Type 2 – displaced stable

Type 3 displaced and humerus subluxed ie unstable
PRXOXIMAL HUMERAL FRACTURES
Deforming forces from rotator cuff and deltoids laterally and pec major
medially
Neer Classification - > 1cm displacement and 450 angulation






1 part – undisplaced
2 part
3 part
4 part
Fracture dislocation
Articular surface fracture
MONTEGGIA FRACTURE
HUMERAL SHAFT FRACTURES
No classification system – anatomical description.

Open vs closed

Location ie proximal / middle / distal 1/3rds

Degree ie displaced or non displaced

Fracture character ie transverse / oblique / spiral / segmental /
comminuted

Articular or non articular extension
NB
90% will heal non operatively
Acceptable positions
1. 200 anteriorly
2. 300 varus
3. 3cm overlap
DISTAL HUMERAL FRACTURES
Fracture patterns:

Supracondylar

Transcondylar

Intercondylar

Capitellum

Trochlea

Epicondylar ie lateral or medial
Supracondylar Gartland extension type (98% of cases) Modified into
A&B.

Type 1 – non displaced

Type 2 – intact posterior cortex
o
A – not rotated
o
B – rotated

Type 3 – complete displacement
Muggers injury thus ulna # with dislocation of the proximal radius
Bado classification

Type 1 – anterior dislocation of radial head

Type 2 – posterior dislocation of radial head

Type 3 – lateral dislocation of radial head

Type 4 - # to both ulna and radius.
GALEAZZI FRACTURE – radial fracture distal to mid point with
DRUJ disruption
ESSEX-LOPRESTI LESIONS - radial head # + dislocation of DRUJ
(& interosseous membrane disruption)
DISTAL RADIUS
Frykman classification
Fracture
Absent ulnar #
Present ulna #
extraarticular
I
II
Intraarticular into
carpal joint
III
IV
Intraarticluar into
DRUJ
V
VI
Intraarticualr into
both carpal and
DRUJ
VII
VIII
THUMB FRACTURES
Bennetts # - partial articular fracture
Rolando # - complete articular fracture at the base of the thumb
metacarpal.
T condylar fracture Riseborough & Radin 1981

Type 1 – undisplaced intra-articular T condylar #

Type 2 – displaced but no rotated intra-articular T fracture

Type 3 – displaced and rotated #

Type 4 – displaced, rotated and comminuted #
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