Fracture classifications Flashcards
1
Q
Scapula Fx (Ideberg)
A
- Ideberg
- I: Anterior avulsion (ant. rim fx)
- IIA: Transverse Fx through glenoid fossa exiting inferiorly
- IIB: Oblique fx through the glenoid fossa exiting inferiorly
- III: oblique fx through the glenoid exiting superiorly and often associated with an acromioclavicular joint injury
- IV: Transverse fx exiting through the medial border of the scapula
- V: combination of type II and type IV
- VI: comminuted glenoid fx
2
Q
Scapula fx (acromial)
A
- Type I: minimally displaced
- Type II: Displaced but does not reduce the subacromiall space
- Type III: Displaced with narrowing of the subacromial space
3
Q
Scapula fx (Coracoid)
A
- Type I: proximal to CC ligaments
- Type II: Distal to CC ligaments
4
Q
AC joint injury
A
- Rockwood grade
- I: AC ligament sprain
- II: AC tear, CC intact but sprained
- III: AC and CC torn with AC dislocation. Deltoid and trapezius muscles are usually detached from the distal clavicle
- IV: III with posterior displacement
- V: III with > 100% displacement
- VI: III with inferior displacement
5
Q
What is a hill-Sachs lesion?
A
- A posterolateral head defect that is caused by an impression fracture on the glenoid rim
- This is seen in 27% of acute anterior dislocations and 74% of recurrent anterior dislocations
6
Q
What is a Bankart Lesion?
A
- “Bony Bankart”
- Associated with glenoid rim fx
- Avulsion of anterio inferior labrum off glenoid rim
7
Q
HAGL lesion
A
- This involves a stretching or tearing of the capsule, usually off the glenoid, but occasionally off the humerus due to avulsion of the glenohumeral ligaments
- humeral avulsion of Glenohumeral lig
8
Q
Proximal humerus classification
A
- Based on # of parts
- A part is defined as displaced if there is > 1 cm of fracture displacement or > 45 degrees of angulation
- 1 part: No displaced fragment (regardless of # of fx lines)
- 2 part: Anatomic neck, surgical neck, GT, or LT
- 3 part: surgical neck + GT or surgical neck _+ LT
9
Q
What is a Helstein-Lewis Fx?
A
-Spiral fx of distal 1/3 of humeral shaft associated with neuropraxia of Radial N.
10
Q
Distal humerus Fx classification (Intercondylar)
A
- Riseborough and Radin . . Intercondylar
- Type I: Nondisplaced
- Type II: Displaced but not rotated
- Type III: displaced and rotated
- Type IV: Displaced, rotated and comminuted
11
Q
Distal Humerus fx . . . Condylar
A
- Milch
- Type I: lateral trochlear ridge left intact
- Type II: Lateral Trochlear ridge part of the condylar fragment (medial or lateral)
12
Q
Distal Humerus Fx . . Supracondylar
A
Gartland
- Based on degree of displacement
- Type I: Nondisplaced
- Type II: Displaced with intact posterior cortex. May be angulated or rotated
- Type III: Complete displacement; posteromedial or posterolateral
13
Q
Capitellum fx classification
A
- Bryan and Morrey
- Type I: (Hahn-Steinthal frag) - involves large part of capitellum
- Type II: (Kocher-Lorenz frag) - Shear fx of articular cartiilage; . . “uncapping of the condyle”
- Type III: severely comminuted (morrey)
- Type IV: Coronal Shear fx with extension into Trochlea (McKee)
14
Q
Olecranon Fractures . . Colton
A
-Colton: Nondisplaced (< 2 mm) or Displaced (Avulsion, T/O, Comminuted, fx-dislocation)
15
Q
Olecranon Fx . . Mayo
A
- Type I fractures are nondisplaced or minimally displaced and are subclassified as either noncomminuted (type IA) or comminuted (type IB)
- Type II fractures have displacement of the proximal fragment without elbow instability; type IIA noncomminuted. Type IIB comminuted
- Type III fx feature instability of the ulnohumeral joint
16
Q
Coronoid process fx class
A
- Regan and Morrey, based on size of fragment
- Type I: avulsion of the tip of the coronoid process
- Type II, a single or comminuted fragment involving 50% of the coronoid process or less
- Type III: a single or comminuted fragment involving > 50% of the process
17
Q
Radial Head Fx classification
A
- Mason
- Type I: Nondisplaced
- Type II: Marginal fractures with displacement (impaction, depression, angulation)
- Type III: Comminuted fractures involving the entire head
- Type IV: Associated with dislocation of the elbow
18
Q
What is an Essex-Lopresti lesion?
A
-This is defined as longitudinal disruption of forearm interosseous ligament, usually combined with radial head fracture and/or dislocation plus distal radioulnar joint injury
19
Q
What is the elbow terrible triad
A
- Elbow dislocation
- Radial Head fx
- Coronoid process fx
20
Q
Elbow instability scale
A
- Morrey
- I: posterolateral rotatory instability: + pivot shift test; lateral ulnar collateral ligament disrupted
- II: Perched condyles; varus instability; lateral ulnar collateral ligament, anterior and posterior capsule disrupted
- IIIa: Posteror dislocation; valgus instability; lateral ulnar collateral ligament, anterior and posterior capsule and posterior MCL disrupted
- IIIb: posterior dislocations; grossly unstable; lateral ulnar collateral ligament, anterior and posterior capsule, anterior and posterior MCL disrupted
21
Q
What is nursemaid’s elbow
A
-Annular ligament stretches and radial head subluxates
22
Q
What is a Monteggia Fx?
A
Proximal ulnar shaft fx + radial head dislocation
23
Q
Fx classification for monteggia fx?
A
- BADO (based on Radial head location)
- I: Anterior disloc. with ant. angulated fx of ulna
- II: Post. Dis. with post angulated fx of ulna
- III: Lat. or anterolat. disloc. with rx of radius AND ulna
- IV: ant. disloc. with a fx of radius AND ulna
24
Q
Monteggia fx are produced by various mechanisms. Describe the mechanisms of injury based on Bado classification?
A
- Type I: Forced pronation of forearm
- Type II: Axial loading of the forearm with a flexed elbow
- Type III: Forced abduction of the elbow
- Type IV: Type I mechanism in which the radial shaft additionally fails
25
What is a Galeazzi fx?
-Fx of the radial diaphysis at the junction of the middle and distal thirds with associated disruption of the distal radioulnar joint
26
What is a Reverse Galeazzi fx
-Distal 1/3 of ulna with associated disruption of the distal radioulnar joint
27
What is a Barton's fx
-FX- dislocation of wrist in which the dorsal or volar rim of the the distal radius is displaced with the hand and carpus
28
What is a Chauffeur fx?-
Radial styloid fx
29
What is a die-punch fx
Depressed fx of Lunate fossa of distal radius
30
Most common location of Scaphoid fx
"waist" . . in the middle
31
Describe the Mayfield progression of perilunate injuries
I: schapho-lunate disruption
II: Luno-capitate disruption
III: Luno-Triquetral disrupation
IV: Lunate (peri) dislocation
32
Perilunate injuries can occur around the greater or the lesser arch . . . describe the difference?
- Greater arc injury: Associated with carpal fx
| - lesser arc injury: Ligamentous injuries
33
Describe the types of fractures to the MC base of thumb
- Type I (Bennett): Volar lip fx
| - Type II (Rolando): Comminuted
34
Describe a Mallet finger
Extensor Digitorum avulsion from distal Phalanx
35
Describe a Jersey finger
-Flexor Digitorum profundus avulsion from P3
36
Describe Gamekeeper's thumb
-Thumb MCP ulnar collateral ligament
37
Describe classification of Sacral Fx?
- Denis class
- Type I: Vertical fx (Zone 1, 2, 3, Lat --> med)
- Type II: Transverse
- Type III: oblique
- Complex: U or H shape
38
Describe the pelvic ring fx classification system
- LC: lateral Compression
- APC: Anteroposterior compression
- VS: Vertical shear
- Young & Bergess
- All LC have transverse fx of pubic rami
- LC I: Sacral compression on side of impact
- LC II: Crescent (iliac wing) fx on side of impact
- LC III: LC-I or LC-II injury on side of impact; contralateral open-book (APC) injury
- All APC have symphyseal diastasis or longitudinal rami fx
- APC I: <2.5 cm symphysis diastasis
- APC II: >2.5 cm pubic diastasis, ST, Ant. SI lig injury
- APC III: complete SIJ disruption . . all ligaments and symphysis
- VS: ST, SS, A + P SI lig disruption + rami fx
39
Which pelvic ring fx are vertically unstable
- LC III
- APC III
- VS
40
This is a classification of acetabular Fxs that describes the fracture pattern. There are 10 fx patterns. 5 elementary and 5 associated
-Judet-Letournel
41
Describe the 10 fx patterns of Judet Letrournel classification of acetabular fx
```
Elementary
-Post. Wall
-Post Column
-Anterior Wall
-Anterior column
Transverse
Associated fxs
-T-shaped
-Post. Column AND wall
-Transverse and post. wall
-Ant column + posterior hemitransverse
-Associated Both-column (ABC)
```
42
Posterior hip dislocation class
- Thompson and Epstein
- Type I: simple with/without insignificant post wall frag
- Type II: Ass. w/ single large post wall frag
- Type III: Ass. w/ comminuted post wall frag
- Type IV: Ass. w/ fx of acetabular floor
- Type V: Ass. with fx of femoral head (Pipkin class)
43
Anteror hip dislocation class
- Epstein
- I (A, B, C) - Superior, including pubic + subspinous
- II (A, B, C) - Inferior, including obturator + perineal
- A: No ass. fx
- B: Ass. Femoral head fx
- C: Ass. Acetabular fx
44
Femoral Head fx classification system
- Pipkin (all w/ assoc. hip dislocations)
- Type I: Fx below fovea capitis femoris
- Type II: Fx above fovea capitis femoris
- Type III: Type I or II + femoral neck fx
- Type IV: Type I or II + acetabular rim fx (usually post. wall)
45
Femoral neck fx class
- Garden . . look at hip notecards
| - Pauwel . . . same as above
46
Intertrochanteric fx classification
- Evans
- IA: Nondisplaced
- IB: 2 parts, nondisplaced
- IIA: 3 part, GT frag
- IIB: 3 part, LT frag
- III: 4 part
47
What is the evans class of intertroch fxs based on?
- Based on prereduction and postreduction stability
- In stable fx patterns, the posteromedial cortex remains intact or has minimal comminution
- Unstable patterns are characterized by greater comminution of the posteromedial cortex
48
What are the 4 features that would make an intertroch fx unstable
- Posteromedial cortex (calcar) comminution
- Subtroch. extension
- Reverse obliquity
- Lateral wall
49
What are the 2 classifications of Subtrochanteric fractures?
- Russell-Taylor
| - Fielding
50
Describe the Russell-Taylor classification of Subtrochanteric fx?
- I: No piriformis fossa extension/involvment
- IA: LT attached to proximal frag (fx below LT)
- IB: LT detached (involnes LT)
- II: Fx involved piriformis fossa
- IIA: Stable medial construct (Calcar)
- IIB: piriformis foss and LT comminution
51
Describe the Fielding classification of subtrochanteric fx?
- I: At the level of LT
- II: < 2.5 cm below LT
- III: 2.5 - 5 cm below
52
Femoral Shaft Fx classification
- Winquist and Hansen
- Based on fx comminution
- I: Minimal or no comminution
- II: Cortices of both fragments at least 50% intact
- III: 50% to 100% cortical comminution
- IV: Circumferential comminution with no cortical contact
53
Classification of Distal Femur fx
- OA/Muller (level of comminution + articular inv.)
- A (1, 2, 3): Extraarticular
- B (1, 2, 3): Unicondylar
- C (1, 2, 3) Bicondylar; articular frag separated from shaft
54
Classification of patellar fx
- Descriptive
- Open vs. Closed
- Nondisplaced vs. displaced
- Pattern: Stellate, comminuted, Transverse, vertical (marginal), polar osteochondral
55
What are the 2 classifications of knee dislocations and what is each based on?
- Kennedy (Direction of displacement of tibia)
| - Schenck (pattern of ligamentous injury)
56
Describe the Kennedy classification of knee dislocation
-Anterior > Post > Lateral > rotational > medial
57
Describe the Schenck classification of knee dislocation
- KD I: ACL or PCL
- KD II: ACL + PCL
- KD III (M/L): ACL + PCL + PMC or PLC
- KD IV: ACL + PCL + PMC + PLC (highest risk of popliteal a. injury)
- KD V: Dislocation + fx
58
Describe the classification of Tibial Plateau fx
- Schatzker
- I: Lateral plateau split fx
- II: Lateral split + depression (most common)
- III: Lateral Depression
- IV: Medial plateau fx
- V: Bicondylar plateau fx
- VI: Fx + metaphysis-diaphysis separation
59
Tibial Plafond (pilon) fx
- Ruedi and Allgower (Comminution and displacement of articular surface)
- I: no to minimal displacement
- II: Displacement w/ minimal impaction or comminution
- III: Displaced w/ comminution + metaphyseal impaction
60
What are the 2 classifications of ankle fxs?
- Weber (location of fibular fx)
| - Lauge-Hansen (Foot position + mechanism or force of impact
61
Describe the Weber classification of ankle fxs?
- Type A: Fx of fibula below the level of the tibial plafond . . supination of foot may be associated with an oblique or vertical fx of medial malleolus . . equivalent to Sup-Add injury of LH class
- Type B: oblique or spiral fx of fibula at level of plafond . . SER LH class
- Type C: fx of fibula above level of plafond and ass. with medial injury PER or PAB III
62
What are the 4 Lauge-Hansen ankle fxs?
- Supination Adduction (SAD)
- Supination External Rotation (SER)
- Pronation Abduction (PAB)
- Pronation External Rotation (PER)
63
Describe stages of SER Lauge-Hansen fx
- I: AITFL +/- avulsion fx of tib/fib attachments
- II: Spiral fx of distal fibula from ant. inferior to Post. superior
- III: PITFL disruption or fx of posterior malleolus
- IV: Trans. avulsion fx of medial malleolus or deltoid lig
64
Describe the stages of SAD Lauge-Hansen fx
I: either transverse avulsion type fx of fibula distal to level of joint or rupture of LCL
II: results in vertical medial malleolus fx *****
65
Describe the stages of a PAB Lauge-Hansen fx
I: either transverse fx of the medial malleolus or a rupture of the deltoid
II: either rupture of the syndesmotic ligaments or an avulsion fx at their insertion sites
III: Transverse or short oblique fx of distal fibula at or above the level of the syndesmosis . . . lateral comminution or a butterfly fragments
66
Describe the stages of a PER Lauge-Hansen fx
I: Transverse fx of medial malleolus or deltoid
II: AITFL +/- avulstion fx of tibial/fibular attachment
III: Spiral fx of distal fibular at or above syndesmosis from Anterior superior to Posterior inferior
IV: PITFL or avulsion fx of posterolateral tibia
67
Correlate Weber injuries to their Lauge Hansen class
- A: SAD
- B: SER
- C: PER or PAB
68
What classification for periprosthetic fx of Total HIp
- Vancouver
- Type A: Fracture in the trochanteric region
- A(G): Greater trochanter region
- A(L): Lesser trochanteric region
- Type B: Around or just distal to the stem
- B1: Stable prosthesis
- B2 Unstable prosthesis
- B3: unstable prosthesis plus inadequate bone stock
- Type C: Well below the stem
69
Describe the classification for lateral ankle ligament sprain
- Mild: Minimal loss of fxn, no limp, min. swelling, point tenderness, pain w/ reproduction of injury mechanism
- Moderate: Moderate loss of fxn, no hop or toe rise, + limp, + swelling, and + point tenderness
- Severe: Diffuse tenderness, swelling, preference for non-weight bearing
70
Syndesmosis sprain grades
- I: diastasis involves lat. subluxation w/o fx
- II: Lat. subluxation w/ plastic deformation of fibula
- III: Post. subluxation/ dislocation of fibula
- IV: Sup. subluxation/ dislocation of talus within mortise
71
What are the 2 calcaneus fx classifications
- Essex-Lopresti
| - Sanders
72
Describe the Essex-Lopresti classification of calcaneus fx
- Primary fx is intraarticular, throught the posterior facet
- Joint depression (secondary fx is just behind post. facet dorsally)
- Tongue type (secondary fx is through tuberosity
73
Describe the Sanders classification of calcaneus fx
- Per coronal CT of post. facet
- I: no displacement
- II: 2 part fx of posterior facet, A, B, C (Lat --> med): base on location of primary fx line
- III: 3 part fx w/ centrally depressed fragment, AB, AC, and BC
- IV: 4 part articular fx, highly comminuted
74
Talar neck fx classification
- Hawkins (predicts risk of AVN)
- I: Non-displaced (<10%)
- II: Subtalar dislocation (40%)
- III: II + tibiotalar dislocation (90%)
- IV: III + Talonavicular dislocation (100%)
75
Tarsal navicular fx classification
- Sangeorzan (fx of navicular body)
- I: splits navicular into dorsal and plantar segments
- II: cleaves into medial and lateral segments
- III: comminution of fragments and significant displacement of medial and lateral poles
76
What are the fx classifications for Tarsometatarsal (Lisfranc) joint?
- Ouenu & Kuss
| - Myerson
77
Describe the Ouenu and Kuss classification of Tarsometatarsal (Lisfranc) joints?
- Based on commonly observed patterns of injury
- Homolateral: All five metatarsals displaced in same direction
- Isolated: One or two metatarsals displaced from the others
- Divergent: Displacement of the metatarsals in both the sagittal and coronal planes
78
Describe the Myerson classification of Tarsometatarsal (Lisfranc) joints?
- Based on commonly observed patterns of injury with regard to treatment
- Total incongruity: Lateral and dorsoplantar
- Partial incongruity: Medial and lateral
- Divergent: Partial and total
79
What are the different fx of the 5th metatarsal base?
- Zone I: (pseudo-jones) - Avulsion fx of proximal tubercle
- Zone II: (Jones) - meta-diaphyseal jxn
- Zone III: proximal 1.5 cm of diaphyseal shaft
80
Fx classification for 1st MTP joint
- Bowers & Martin
- I: Strain @ proximal attachment of volar plate from 1st MT head
- II: Avulsion of volar plate from MT head
- III: Impaction of dorsal surface of MT head +/- avulsion chip fx
81
Classification of Spinal cord injury
- Frankel
- A: Absent motor and sensory fxn
- B: Absent motor fxn; sensation present
- C: Motor fxn present but not sueful (2-3/5); Sensation present
- D: Motor fxn present & useful (4/5); sensation present
- E: Normal motor (5/5) and sensory fxn
82
Fx classification for spondylolisthesis (forward displacement of vertebrae, especially L5 over S1)
- Myerding
- I: <25%
- II: 25-50%
- III: 50-75%
- IV: 75-100%
- V: > 100% (spondyloptosis)
83
What are the Classifications for periprosthetic fractures around a Total Knee?
- Lewis & Rorabeck (supracondylar)
- Felix (Tibial fx)
- Goldberg (patella)
- Stability of implant subtypes
84
Describe the Lewis and Rorabeck periprosthetic knee fxs?
- Supracondylar
- I: nondisplaced, bone-prosthesis interface intact
- II: Displaced, interface intact
- III: Loose or failing prosthesis w/ displaced or nondisplaced fx
85
Describe the Felix periprosthetic knee fxs?
- Tibial
- I: occur in tibial plateau
- II: Adjacent to stem
- III: Distal to prosthesis
- IV: involved tibial tubercle
86
Describe the Goldberg periprosthetic knee fxs?
- Patella
- I: not involving cement/implant composite or quadriceps mechanics
- II: Involving cement/implant composite and/or quad mechanics
- IIIA: Inferior pole fx w/ patellar ligament disruption
- IIIB: Inferior pole w/o patellar ligament disruption
- IV: Fx-dislocation
87
Total Shoulder periprosthetic fx classification
- University of Texas San Antonio
- I: proximal to tip of humeral prosthesis
- II: proximal humerus w/ distal extension beyond stem tip
- III: Entirely distal to tip of humeral prosthesis
- IV: Adjacent to glenoid prosthesis
88
Total Elbow periprosthetic fx classification
- Type I: fx proximal to humeral component
- Type II: Humerus or ulna in an location along length of prosthesis
- Type III: Distal to ulnar component
- Type IV: Fx of implant
89
Classification of Open Fxs?
- Gustilo & Anderson
- I: Wound < 1 cm
- II: Wound 1-10 cm
- IIIA: > 10 cm, high energy, adequate tissue for coverage, extensive comminution fxs (even if wound < 10 cm)
- IIIB: Extensive periosteal stripping; inadequate tissue for coverage; requires free soft tissue transfer
- IIIC: Vascular injury requiring repair
90
What is the Tscherne Classification of closed Fxs?
Grade 0: Minimal soft tissue damage, indirect injury to limb (torsion), simple fx pattern
- Grade 1: Superficial abrasion or contusion, mild fx pattern
- Grade 2: Deep abrasion, skin or muscle contusion, severe fx patter
- Grade 3: Extensive skin contusion or crush injury, severe damage to underlying muscle, compartment syndrome
91
Classification of Chondromalacia?
- Outerbridge
- I: Softening of articular cartilage
- II: "crabmeat" appearance; some fissuring
- III: Fissures reach down to bone
- IV: Areas of visibly exposed bone
92
Classifications of Discoid meniscus tears?
- Wantanabe
- I: Complete
- II: Incomplete
- III: Wrisberg (no post. meniscotibial attach to tibia)
93
ACL injury classification
- Lachman test (knee in 20-30 degree flexion)
- I: < 5 mm translation
- II (A/B): 5-10 mm translation
- III (A/B) - > 10 mm translation
- A: firm endpoint
- B: no endpoint
94
PCL injury classification
- Posterior Drawer test (knee in 90 degrees flexion)
- I (partial isolated): 1-5 mm post. translation of tibia; Tibial remains ant. to femoral condyles
- II: Complete isolated: 6-10 mm post. translation; Ant. Tibia flush w/ femoral condyles
- III (PCL + capsuloligament) - > 10 mm post translation; Tibia post. to condyles; assoc. ACL and/or PLC injury
95
MCL injury (sprain) grades
- I: stretch injury, intact ligamentous integrity, min. torn fibers
- II: partial MCL tear, joint laxity, fibers remain apposed, (+) endpoint @ 30 degrees flexion w/ valgus stress
- III: complete MCL tear, gross laxity, no endpoint
96
LCL injury (sprain) grades
- I Minimal ligamentous disruption
- II: partial
- III: complete
97
PLC injury grades (also for MCL/LCL laxity testing @ 30 degrees flexion)
- I: 0-5 mm lat opening + minimal ligament disruption
- II: 5-10 mm lat opening + moderate ligament disruption
- III: > 10 mm lat opening + severe lig disruption + no endpoint
98
What are the classifications of SLAP lesions?
- Snyder
| - Maffet (sub-classification)
99
Describe the Snyder classification of SLAP lesions?
- I: Labral and biceps fraying, anchor intact
- II: Labral fraying with detached biceps tendon anchor
- III: Bucket handle tear, intact biceps tendon anchor (biceps separates from bucket handle tear)
- IV: Bucket handle tear with detached biceps tendon anchor (remains attached to bucket handle tear)
100
Describe the Maffet classification of SLAP lesions?
- V: Type II + anterointerior labral extension (Bankart lesion)
- VI: Type II + unstable flap
- VII: Type II + MGHL injury
- VIII: Type II + posterior extension
- IX: circumferential
- X: Type II + posteroinferior extension
101
What fx? Avulsion fx of posterior tibia
-Curbstone
102
What fx? Anterior fibular tubercle avulsion by AITFL
LeFord-Wagstaffe
103
What fx? Avulsion of Anterior tibial margin by AITFL
Tillaux-Chaput
104
What fx? PER-type injury; complete syndesmosis disruption and diastasis + proximal fibula fx
Maisonneuve
105
Classification for lateral epicondyle fx
Milch
- Type I: lateral to trochlear groove, does NOT enter trochlear groove
- Type II: fx line extends medially into trochlear (more common, unstable)
106
Classification for Jersey finger (FDP rupture)
- Leddy and Packer classification
- based on level of tendon retraction and presence of fx
- Type I: FDP tendon retracted to palm (leads to vascular disruption)
- Type 2: retracts to PIP joint
- Type 3: Large avulsion fx limits retraction to level of DIP joint
- type 4: osseous fragment and simultaneous avulsion of tendon from fx fragment
- Type 5: ruptured tendon with bone avulsion with bony comminution of remaining distal phalanx
107
2 classifications of nerve injury
- Seddon
| - Sunderland
108
describe Seddon classification of nerve injury
- Neuropraxia: local myelin damage (often from compression or local ischemia), axon intact with NO wallerian degerneration
- Axonotmesis: axon and myeline sheath disruption leads to conduction block with Wallerian degeneration, endoneurium remains intact
- Neurotmesis: complete nerve division with disruption of endoneurium
109
Describe sunderland classification of nerve injury
- 1st degree: local myelin damage (same as seddon's neuropraxia)
- 2nd: Axon and myelin disruption . .same as Axonotmesis
- 3rd: injury with endoneurial scarring
- 4th: nerve in continuity but at the level of injury there is complete scarring across nerve
- 5th: all layers disrupted
- 3 through 5 are included in seddon's neurotmesis
110
Classification for Basilar thumb arthritis
- Eaton and Littler
- Stage 1: Slight joint space widening (pre-arthritis)
- Stage 2: Slight narrowing of CMC joint with sclerosis, osteophytes < 2 mm
- Stage 3: Marked narrowing of CMC joint with osteophytes > 2 mm
- Stage 4: Pantrapezial arthritis (STT involved)
111
what classification system is used to guide indication for cemented or uncemented femoral component fixation in a THA?
Dorr classification
112
describe dorr classification
- Type A: Ratio <0.5, cortices seen on both AP and lateral XR, uncement
- Type B: ratio .5 to .75, thinning of posterior cortex on lateral XR, uncemented
- Type C: ratio >.75, thinning of cortices on both views, ("stovepipe" femur), Cement
