Medic: Classification of fracture #

Assalamualaikum. =)

Since I'm in posting orthopaedics now, so lets' learn about classification of fracture.

1) Gustilo open fractures classification

Type I:

• Wound less than 1 cm with minimal soft tissue injury
• Wound bed is clean
• Fracture is usually a simple transverse, short oblique fracture, with minimal comminution

Type II:

• Wound is greater than 1 cm with moderate soft tissue injury
• Fracture is usually a simple transverse, short oblique fracture, with minimal comminution

Type III:

• Fractures that involve extensive damage to the soft tissues, including muscle, skin and neurovascular structures
• Often accompanied by a high-velocity injury or a severe crushing component
• Special patterns classified as Type III:
  
  • Open segmental fracture, irrespective of the size of the wound
  • Gunshot wounds -high velocity and short-range shotgun injuries
  • Open fracture with neurovascular injury
  • Farm injuries, with soil contamination, irrespective of the size of the wound
  • Traumatic amputations
  • Open fractures over 8 hours old
  • Mass casualties; eg, war and tornado victims
• Subtype IIIA
  
  • Adequate soft tissue coverage despite soft tissue laceration or flaps or high energy trauma irrespective of the size of the wound
  • Includes segmental or severely conminuted fractures
• Subtype IIIB
  
  • Extensive soft tissue lost with periosteal stripping and bony exposure
  • Usually associated with massive contamination
• Subtype IIIC
  
  • Fracture in which there is a major arterial injury requiring repair for limb salvage

Explanation

Gustilo open fracture classification classifies into three major categories (types) depending on the mechanism of the injury, soft tissue damage, and degree of skeletal involvement.

2) Allman classification of clavicle fractures

 

GROUP I – Middle third fractures (80%)

GROUP II – Distal third fractures (15%)

• Type I – Minimally displaced / interligamentous
• Type II – Displaced fractures, fracture medial to the coracoclavicular ligaments
  
  • IIA – Both ligaments (conoid and trapezoid) attached to the distal fragment
  • IIB – Conoid torn, trapezoid attached to the distal fragment
• Type III – Fractures involving articular surface
• Type IV – intact coracoclavicular ligaments attached to periosteal sleeve plus proximal fragment displaced
• Type V – Comminuted

GROUP III – Fracture of the proximal third (5%)

• Type I – Minimally displacement
• Type II – Displaced
• Type III – Intra-articular
• Type IV – Epiphyseal separation
• Type V – Comminuted

3) Fracture of radial head- Mason classification

Type I: An undisplaced fracture of the radial head

Type II: A marginal radial head fracture with minimal displacement, depression, or angulation

Type III: A comminuted radial head fracture

Type IV: A radial head fracture with elbow dislocation

 

4) Fracture of femoral neck - Garden Classification

 

5) Tile classification of Pelvic Fractures

6) Danis-Weber classification of ankle fractures

-based on level of fibular fracture relative to syndesmosis

• type A
  
  • below level of the ankle joint
  • tibiofibular syndesmosis intact
  • deltoid ligament intact
  • medial malleolus often fractured
  • usually stable : occasionally nonetheless requires an open reduction and internal fixation (ORIF)
• type B
  
  • at the level of the ankle joint, extending superiorly and laterally up the fibula
  • tibiofibular syndesmosis intact or only partially torn, but no widening of the distal tibiofibular articulation
  • medial malleolus may be fractured or deltoid ligament my be torn
  • variable stability
• type C
  
  • above the level of the ankle joint
  • tibiofibular syndesmosis disrupted with widening of the distal tibiofibular articulation
  • medial malleolus fracture or deltoid ligament injury present
  • unstable : requires ORIF

ok.that's all for today. i will continue later. Insyaallah. Make sure you all know about this classification ok?

ok.daa. wsalam:))