Classifications Flashcards
Classification of Galleazzi fractures
Walsh JBJSBr 1987
Type 1 - volar apex and volar dislocation - supination injury
Type 2 - dorsal and dorsal. Probation injury
Classification of Monteggia fractures
Badot
Type 1 - apex anterior with anterior dislocation
Type 2 - apex posterior with posterior dislocation
Type 3 - apex lateral with lateral dislocation
Type 4 - any direction fracture with proximal ulna and radial head fracture-dislocation
Classification of Bipartite patella
Saupe classification
Type 1 - inferior pole 5%
Type 2 - lateral pole 20%
Type 3 - superolateral 75%
Saupe H, Deutshe Z Chir 1943;258:386
Classification of Paediatric hip fracture
Delbet
Type 1 - transepiphyseal 10% (AVN 100%)
Type 2 - transcervical. 50% (AVN 50%)
Type 3 - cervicoteochanteric 30% (AVN 25%)
Type 4 - inter trochanteric 10% (AVN 10%)
Type 1 - 50% dislocations. THINK NAI
Classification of infantile Blount’s
Langenskiold
1 beaked Metaphysis 2 saucer shaped defect 3 stepped defect 4 bent physeal plate 5 double epiphysis 6 physeal bar
Classification of acromial fractures
Kuhn
1 - non displaced or minimally displaced
2 - Displaced but does not compromise the subacromial space
3 - Displaced but compromises the subacromial space
Classification of scapula fractures
Ada and Miller
1a - acromial
1b - scapular spine
1c - coracoid
2a - glenoid neck
2b - glenoid neck
2c - glenoid neck
3 glenoid fractures
4 body fractures
Classification of glenoid fractures
Mayo modification of Ideburg classification
1- ant/inferior -bankart
2- superior 1/3 to 1/2 displaced articular in continuity with coracoid
3- inferior 1/2 extending to lateral border
4- inferior articular surface extending to body
5- type 4 plus coracoid, acromial or free superior articular component
What are the classifications used for LCP disease - Perthes
Herring - lateral pillar height Group A - no involvement lateral pillar Group B - >50% maintained LP height Group B/C 50% maintained LP height Group C -
At risk signs for perthes - Catterall
Gage sign / radiolucency in shape of V in lateral epiphysis
Calcification lateral to epiphysis
Laterally subluxed femoral head
Horizontal physis
Late changes of Perthes in proximal femur and head shape
Coxa breva Coxa Magna Coxa plana Coxa vara Sagging rope sign GT overgrowth Shortening
Classification of perilunate instability
Mayfield
1 - scapholunate ligament
2 - SL and LC
3 - SL and LC and LT - dorsal perilunate dislocation
4 - volar lunate dislocation
Fracture - trans’bone’ perilunate dislocation
Classification of Hamatometacarpal fracture dislocation
Cain
1a - ligamentous - stable-cast, unstable -CRPP
1b - dorsal hamate fracture - stable-cast, unstable - ORIF
2 - comminuted dorsal hamate. -ORIF to restore dorsal buttress
3 - coronal hamate fracture - ORIF to restore congruent joint surface
CRPP - CR with per cutaneous pinning
Causes of Erlenmeyer flask deformity
C - cranio Metaphyseal dysplasia H - Haemoglobinopathies - sickle O - OI N - Niemann pick G - Gauchers
M - MPS
M - MHE
M - metal poisoning
Pyles
Lead poisoning
Classification of navicular fractures
Tuberosity
Avulsion
Stress
Body
Sangeorzan
Type 1 - transverse
Type 2 - oblique
type 3 - central
Poor central blood supply
Undisplaced - non-op
Displaced - ORIF
Classify paediatric pelvis fractures
Torode and Zieg
1- avulsion
2- iliac wing
3- simple ring
4- disrupted ring
Tile A- stable vertically and rotational A1 not involving the ring A2 involving the ring B- vertically stable but rotational unstable B1 open book B2 lateral compression/ipsilateral B3 lateral compression/contra lateral C- unstable in both Unilateral/bilateral/associated with acetabular fracture
Young and Burgess Lat compression LC1- sacral on side of impact LC2- crescent on side of impact LC3- 1or2 with contralateral open book AP Compression APC1- minor opening symphysis and anterior SI APC2- opening anterior SIJ and intact posterior SIJ APC3- complete SIJ VS - vertical shear CM - combined mechanism
What is the classification of soft tissues for fractures.
Tscherne
Grade 0 - 1 2 3 4
What is the classification of pilon fractures
Ruedi-Allgower
1- undisplaced
2- displaced / minimally comminuted
3- displaced / highly comminuted
What is the MESS score
Age 0,1,2
BP 0,1,2
Circulation 1,2,3 (x2)
Degree of injury 1,2,3,4
Critic
Score is 7
>=7 amputation
50
BP always >90, transiently hypotensive, persistent
Normal perfusion, pulse less decreased cap refill, cool paralysed insensate (x2 >6 hours ischaemia)
Low energy, medium, high, very high
What is classification of acetabular fractures?
Judet & Letournel
Elementary 1-posterior wall 2-posterior column 3-anterior wall 4-anterior column 5-transverse - trans, juxtra, infra-tectal Associated 1-PW & PC 2-PW & transverse 3-AC & hemitransverse 4- T-type 5- both column
What is the classification of trigger finger
Green
1- Palm pain and tenderness A1 pulley
2- catching of digit
3- locking of digit, passively correctable
4- flexed, locked digit
Classification of loosening in THR
Harris
Possibly - incomplete Lucent line >50% at cement-bone interface
Probably - continuous Lucent line at C-B interface
Definitely loose -
- subsidence
- cement mantle fracture
- implant fracture
How do you classify bony defects in a THR
AAOS
Acetabular 1 - Segmental deficiency 2 - Cavitatory deficiency (intact A & P columns) 3 - Combined deficiency 4 - Pelvic discontinuity 5 - Arthrodesis
Femur 1 - Segmental deficiency 2 - Cavitatory deficiency 2a - Cavitatory only 2b - Ectasia (femoral expansion) 3 - Combined deficiency 4 - Malalignment 5 - Stenosis 6 - Femoral discontinuity
Segmental needs Structural BG
Cavitatory needs non-structural BG
P/F discontinuity requires Healing Bone Bridgjng Fixtion
Paprosky
Based on severity of bone loss and ability to obtain cementless fixation
Based on integrity of
Superior migration of hip centre, ischial osteolysis, acetabular teardrop osteolysis, and position of implant relative to Kohler’s line
1) TYPE 1
Rim intact with no significant rim distortion. Columns intact acetabulum hemispherical. Small focal areas contained bone loss. Kohler line not violated. No migration of component and no osteolysis Hemispherical uncemented implant
2) TYPE 2
2a – Columns and rim intact. Bone loss superior and medial. Hip centre migrated superiorly. Migration 3cm migration, moderate ischial lysis and intact Kohler line
Hemispherical cup will have 1/2 circumference
Failed component has migrated superiorly and medially
High risk of pelvic discontinuity – recontruict posterior column.
Massive allograft and revonstruction cages
Classification of Freiburgs
Smilie
1-5 1- pre xray 2- sub chondral collapse dorsal 3- Collapse only plantar left 4- Complete MT head collapse 5- Degenerative OA
Classification of Kienbocks
Lichtmann
1- norm xray or linear fracture 2- lunate sclerosis 3- lunate collapse 3a - Normal carpal height 3b - Decreased carpal height /proximal migration capitate / ring sign 4- pancarpal arthritis
Classifications of humeral head AVN
Cruess
1- normal xray. Seen on mri 2- sclerosis and osteopaenia 3- crescent sign 4- flattening and collapse 5- degenerative changes to glenoid
What are the classifications for Charcot?
Eichenholtz 0- preradiological 1- Fragmentation 2- Coalescence 3- Reconstruction
Brodsky 1- TMTJ & IMTJ - mid foot 2- Peritalar 3a- Ankle 3b- calcaneal fracture 4- combination 5- forefoot only
Schon
Pattern of deformity
Complex and no evidence for its use
Classifications for OCD of knee and of ankle
Clanton and Delee for knee
Same as -
ANKLE
Berndt & Harty (X-rays)
Gd 1- Stable, not detached/undisplaced
Gd 2- Stable, partially detached/undisplaced
Gd 3- Unstable, completely detached/undisplaced
Gd 4- Unstable, completely detached/displaced (loose)
Ferkel- MRI
Pritsch - Arthroscopy
What is the classification of peroneal retinaculum tears - peroneal tendon instability
Gd 1- SPR partially elevated off fibula allowing big tendons to sublux
Get 2- SPR separates off cartilaginous ridge of lateral malleolus allowing tendons to sublux between SPR and cartilaginous ridge
Gd 3- Cortical avulsion of SPR off fibula allowing subluxed tendons to move underneath the cortical fragment
Gd 4- SPR torn from calcaneus not fibula
What is. Classification for hallux rigidus?
Coughlin
0- 60 degrees / X-ray norm
1- 40 / dorsal osteophyte
2- 30 / dorsal and lateral or medial o’phyte
3-
What are your classification systems of osteomyelitis?
Acute (sup abscess), chronic (involucrum and sequestrum)
Direct or indirect
Cierny-Mader staging
Anatomical location - 1,2,3,4
Physiological status of host - A, BL, BS, C
Anatomic - medullary, superficial, localised, diffuse
Status - normal, local, systemic, treatment worse than infection
Classification of HO at the knee
Rader
1- lesion 5cm in one location
3- lesion >5cm in 2 locations
Classification of Supracondylar periprosthetic knee fractures
Rorabeck and Lewis 1999
Type 1 - non-displaced and stable
Type 2 - displaced and stable
Type 3 - unstable - non or displaced
SU
Type 1 - above level of femoral component
Type 2 - at level of
Type 3 - Below level
Classification of tibial periprosthetic knee fractures
Felix 1997
Type 1 - tibial plateau
Type 2 - adjacent tibial stem
Type 3 - distal to stem
Type 4 - tibial tubercle
Classification of patella periprosthetic fracture
Goldberg
Type 1 - not involving implant or quads
Type 2 - involving implant and / or quads
Type 3 -
- a inferior pole # with patella ligament rupture
- b inferior pole # without ligament rupture
Type 4 - all types with # dislocations
Classification of OCD at knee
Papas - age at presentation. 1-3. Open to closed physis.
Clanton and DeLee - X-rays 1- Stable / not detached / undisplaced 2- partially detached 3- unstable and detached 4- displaced
Cahill and Berg
Split AP into 5 and lateral into 3. 15 zones
2 c most common
Shoulder arthritis - both OA and CTA
Walch
A- concentric, B- eccentric , C- retroverted
Seebauer
1- centred a) mild, b) moderate
2- decentred a) severe b) antsup escape
Classification of periprosthetic THR fractures - not bone defects
Paprosky 1- Intra op # primary THR 2- intra op # revision THR 3- traumatic # 4- atraumatic # 5- pelvic discontinuity
Peterson and Lewallen
1- # associated with clinical and radiological stable component
2- # associated with unstable acetabular component
Classification of Acromion morphology
Bigliani
Tyep 1 - Flat 17%
Type 2 - Curved 43%
Type 3 - Hooked 40%
Classification of stages of RC degeneration
Neer
Stage 1 - Oedema and haemorrhage
Stage 2 - Fibrosis and tendinitis
Stage 3 - Bone spurs and RCT
Classify RC tears by size
Small - 5cm involving 2 or more tendons
Classify RC tears by chronicity
Acute 3 months
Classify RC tears by degree of retraction
Patte CORR 1990
Type 1 - Stump close to bony insertion
Type 2 - Stump retraction to level of humeral head
Type 3 - Stump retraction to level of glenoid
Classify Partial thickness RC tears
Ellman -
Size - 6
Location - A-articular, B-bursal, C- interstitial
PASTA - partial articular Supra tendon avulsion
PAINT - Partial thickness articular surface intra-tendinous tears
Habermayer - Coronal and sagital classifications
Tear ranging from cartilage bone transition laterally to GT &
From coracohumeral ligament medially to Supra tendon into crescent zone
Classify RC tears by fatty infiltration
Goutallier COOR 1984 - CT scans MRI scans is Fuchs & Thomazeau 0 - Normal 1 - fatty streaks 2- 50%
Thomazeau - T1 images
1 - Normal or slight atrophy
2 - Moderate
3 - Serious or severe
What is abnormal AHI
Normal range - 7-14mm mean 10.5mm
If
