Tile / Denis / Young-Burges classification

Tile A

A1 Avulsion injury. Not involving the ring

A2 Stable. Minimal displacement

A3 Transvers fracture of sacrum or coccis

Tile B

B1 Unilateral

B2 Lateral compression injury. Internal rotation instability

B3 Bilaterally rotational instability

Type C

C1 Unilateral

C2 Bilateral. one side rotational unstable. One side vertically unstable

C3 Bilaterally vertically unstable

Tlle images

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 Denis
zone 1

fracture lateral to foramina

most common (50%

nerve injury rare 5%

usually occurs to L5 nerve root

zone 2

fracture through foramina

may be stable vs. unstable

zone 2 fracture with shear component highly unstable

unstable fractures have increased risk of nonunion and poor

functional outcome

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 zone 3

fracture medial to foramina into the spinal canal

highest rate of neurologic deficit (60%

bowel, bladder, and sexual dysfunction

Transverse sacral fractures

higher incidence of nerve dysfunction

U-type sacral fractures

results from axial loading

represent spino-pelvic dissociation

high incidence of neurologic complications

Young-Burges Classification
Anterior Posterior compressoin

Lateral compression
Vertical Shear

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 Leturnel & Judet

Leturnel&Judet
 Posterior wall

 Posterior column

 Anterior wall

 anterior column

 Transverse

 Posterior wall + posterior column

 Posterior wall + transverse

 T - shaped

 Anterior wall + posterior hemi transverse . Y-shape.

 Both columns.

entire weight-bearing portion of the acetabulum is disconnected from the

sciatic buttress

acetabular roof mostly remains with the anterior column fragment(s)

Pipkin/Garden/Pawels

Pipkin
Classification based on location of fracture relative to fovea and presence or
absence of associated fractures of the acetabulum or femoral neck.
• Type I—fracture below fovea
• Type II—fracture above fovea
• Type III I/II associated femoral neck fracture
• Type IVI/II associated acetabular fracture

Garden

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 Grade I is an incomplete impacted fracture in valgus malalignment
(generally stable).

Grade II is a nondisplaced fracture.

Grade III is an incompletely displaced fracture in varus malalignment.

Grade IV is a completely displaced fracture with no engagement of the two

fragments.

Powels
Pawels classification (an angle with horizontal line)

 I 30 degree

 II 3050 degree

 III 50 degree

Evans/ AO/Seinsheimer

Evans

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 AO

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 Winquist&Hansen

I Transverse or short oblique fractures with no comminution or a small

butterfly fragment of less than 25% of width of the bone

II Comminuted with a butterfly fragment of 50% or less of the width of the

bone

III Comminuted with a large butterfly fragment of greater than 50% of the
width of bone

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 IV Segmental comminution

Neer/Seinsheimer
Seinsheimer classification :
Type I : Non-displaced fractures ( less than 2mm displacement )

Type II : Distal metaphyseal fractures ( Extra-articular )

IIA : 2 part fractures

IIB : Communited fractures

Type III : Fractures involving the intercondylar notch in which one or both
condyles are separate fragments

Type IV : Intra-articular fractures

IVA : Medial condyle fracture
IVB : Lateral condyle fracture

IVC : Comminuted fractures

Neer classification

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 Schatzker classification/10 quadrans/3 part classification

Schatzker I wedge-shaped pure cleavage fracture of the lateral tibial plateau,

originally defined as having less than 4 mm of depression or displacement
Schatzker II splitting and depression of the lateral tibial plateau; namely, type I
fracture with a depressed component
Schatzker III pure depression of the lateral tibial plateau; divided into two
subtypes: a lateral b central
Schatzker IV medial tibial plateau fracture with a split or depressed
component
Schatzker V wedge fracture of both lateral and medial tibial plateau
Schatzker VI transverse tibial metadiaphyseal fracture, along with any type of
tibial plateau fracture (metaphyseal-diaphyseal discontinuity)

The current four-quadrant tibial plateau classification involves four articular

surfaces, two intercondylar spines ACL and PCL insertion), and one anterior
tibial tuberosity (patella tendon attachment). AM

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 anteromedial quadrant, PM posteromedial quadrant, AL anterolateral
quadrant, PL posterolateral quadrant, a-ICS ACL attachment, p-ICS
PCL attachment, ATT anterior tibial tuberosity

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 Segond #/ Reverse Segond #/Hoffa#

Segond #
Is an avulsion fracture of the knee that involves the lateral aspect of the tibial
plateau and is very frequently 75% of cases) associated with disruption of
the anterior cruciate ligament ACL and detachment of capsular portion of the
lateral collateral ligament.
Additional injury to menisci and other supporting ligaments
On the frontal knee radiograph, it may be referred to as the lateral capsular
sign.
Usually results from excessive internal rotation and varus stress resulting in
increased tension on the lateral capsular ligament of the knee joint.

Reverse Segond #

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 Avulsion fracture of the tibial attachment of the deep portion of the medial
collateral ligament of the knee. We report a reverse Segond fracture
associated with anterior cruciate ligament tibial avulsion fracture and
anteromedial tibial rim fracture.

Hoffa #
Intra-articular distal femoral in the coronal plane.

Ruedi Algower
Type I Nondisplaced cleavage fracture of the ankle joint.
Type II Displaced fracture with minimal impaction or comminution.
Type III Displaced fracture with significant articular comminution &
metaphyseal impaction.

Lange- Hansen / Pott / Weber / Herscovich /

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 Lauge-Hansen classification

 Supination external rotation SER Weber B 60%

anterior (antero-inferior) tibiofibular ligament sprain

short oblique fibula fracture (weber B, anteroinferior to

posterosuperior)

posterior inferior tibiofibular ligament rupture/posterior malleolus

avulsion fracture

transverse medial malleolus fracture/deltoid ligament rupture HC

 Supination adduction SAD Weber A 25%

transverse distal fibula avulsion fracture/talofibular ligament sprain

vertical medial malleolus fracture and possible anteromedial tibial

plafond impaction HD

 Pronation external rotation PER Weber C 20%

transverse medial malleolus fracture or deltiod ligament rupture

anterior tibiofibular ligament rupture (or avulsion of Chaput's

tubercle/Wagstaff Le Forte)

short oblique or spiral high fibula fracture

posterior inferior tibiofibular ligament rupture (or posterior

malleolus avulsion fracture)

 Pronation abduction

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 Herscovich

A Avulsion fracture of the anterior colliculus involving the superficial

deltoid ligament
B Fracture at the level of the plafond Lauge-Hansen external rotation-
abduction type)
C Intermediate fracture
D Plafond fracture Lauge-Hansen suppination adduction type)

Weber

type A - infrasyndesmotic LH SAD

type B - transsyndesmotic LH SER

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 type C - suprasyndesmotic LH PER

Ankle eponims

Pott # (= Dupuytren without syndesmotic injury)

Dupuytren # (# at 27 cm above to distal TF syndesmosis +syndesmotic

injury+disruption of MCL/Tibial malleolar fracture

Maisonneuve #

Wagstaff le Fort (vertical # of the antero-medial part of the distal fibula

with avulsion of anterior tibiofibular ligament)

Tillaux-Chaput #

Chaput's tubercle # (# of the anterior tubercle of the tibia)

Volksman's # (# of the posterior tubercle of the tibia)

Bosworth #

Syndesmotic injury (intraoperative stress view/direct inspection with a bone

hook)
Intraoperative stress view (apply external rotation stress + mortise view
radiograph) →check medial clear space/tibiofibular clear space

Tarsal bones # Hawkins/ Bohler / Guisane/ Sanders / Essex- Lopresti

Metatarsal bones # /Jones/ Pseudojones/Lisfranck

Salter-Harris

S-A-L-T-R

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