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General Classifications > General Classifications > Flashcards

General Classifications Flashcards

1
Q

Achilles Tendon Rupture

A

Kuwada
Type I: partial tear of <50%. Treatment is closed
Type II: Complete tear with defect after debridement <3cm. Use end to end attachment
Type III: Complete tear with defect after debridement 3-6cm. Treatment is end to end attachment and tendon flap.
Type IV: complete tear with defect after debridement >6cm. Treatment is end to end, recession or graft

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2
Q

Open Fractures

A

Gustilo and Anderson
Type I: Open fracture with wound <1cm and clean
Type II: open fracture with a laceration >1cm without extensive soft tissue damage
Type III: Open fracture with extensive soft tissue damage
IIIA: adequate soft tissue coverage
IIIB: extensive soft tissue damage with periosteal stripping
IIIC: open fracture associated with arterial injury

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3
Q

Ruedi and Allgower

A

Pilon fracture classification
Type I: mild displacement and no comminution without major disruption of the ankle joint
Type II: moderate displacement and no comminution with significant displacement of the ankle joint
Type III: Explosion fracture, severe comminution and displacement

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4
Q

Ankle Fractures (2)

A

Lauge-Hansen and Danis Weber

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5
Q

Lauge hansen classifications (4)

A

Supination-adduction
Supination external rotation
Pronation abduction
Pronation external rotation

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6
Q

Danis Weber Classifications (3)

A

A: Transverse avulsion of the fibula below the level of the ankle joint
B: spiral, oblique fracture of the fibula at the level of the ankle joint
C: fracture of the fibula above the level of the ankle joint

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7
Q

Supination Adduction (2)

A

Danis Weber A
I: Transverse fracture of the fibula
II: Vertical fracture of the medial malleolus

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8
Q

Supination External Rotation (4)

A

Danis Weber B
I: Rupture of the anterior tib-fib ligament (Wagstaffe or Tillaux-Chaput)
II: Spiral fracture of the fibula with a posterior spike
III: Rupture of the posterior tib-fib ligament (VolKmann’s fracture)
IV: Avulsion fracture of the medial malleolus

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9
Q

Pronation Abduction (3)

A

Danis- Weber B
I: Transverse fracture of the medial malleolus
II: Rupture of the anterior and inferior tib-fib ligaments
III: Fibular fracture at the level of the ankle with the appearance of a spiral fracture on AP and transverse fracture on the lateral

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10
Q

Pronation External Rotation (4)

A

Danis Weber C
I: Avulsion fracture of the medial malleolus
II: Rupture of the anterior inferior tib-fib ligament (Wagstaffe or Tillaux-Chaput)
III: Short oblique fibular fracture above the ankle joint
IV: Rupture or avulsion fracture of the posterior inferior tib-fib ligament (Volkmann’s)

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11
Q

Volkmanns Fractures (4)

A

A: Large intra-articular fracture (>25%) with displacement
B: Small intra-articular fracture (<25%) with impaction
C: small fracture with minimal impaction and articular damage
D: Avulsion of the posterior inferior tib-fib ligament without articular involvement

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12
Q

Ankle Sprains How to test

A

Anterior Draw test- ATF

Talar Tilt- CF

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13
Q

Physeal plate trauma

A

Salter Harris
I: Complete transverse separation of the epiphysis from the metaphysis through the physis
II: Epiphysis is separated from the physis with the fracture extending into the metaphysis (Thurston-Holland sign)
III: Partial separation of the physis with an intra-articular break into the epiphysis
IV: Intra-articular fracture extending from the epiphysis into the metaphysis resulting in comminution
V: Impaction of the epiphysis into the physis and metaphysis resulting in comminution

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14
Q

Talar Neck Fractures

A

Hawkins
I: vertical fracture of the talar neck without displacement
II: vertical fracture of talar neck with dislocation of the talar body from the STJ
III: Vertical fracture of the neck of the talus, dislocation of the STJ and ankle
IV: Type III with addition of the talo-navicular joint

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15
Q

Talar Dome Fractures

A

Berndt and Hardy
Stage I: Osteochondral compression of the talar dome
Stage II: Partially detached, non displaced osteochondral fracture
III: Completely detached, non displaced osteochondral fracture
IV: displaced osteochondral fracture

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16
Q

Talar Dome fractures MOI

A

DIAL A PIMP
Posterior-Medial lesion: Plantarflexion and inversion
Anterior lateral lesion: Dorsiflexion and inversion

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17
Q

Talar Body fractures (just the two used)

A

Boyd and Knight/ Sneppen

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18
Q

Boyd and Knight

A

Type I: Coronal or Sagittal Shear fracture
IA: non displaced
IB: fracture with displacement at the talo-crural joint
IC: Type B with additional displacement at STJ
ID: Fracture with total displacement of the talar body

Type II: Horizontal shear fracture
IIA: non-displaced
IIB: displaced

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19
Q

Sneppen

A 
I: Compressive fracture of the talar dome usually involves the medial or lateral aspect
II: Shearing fracture of talar body
IIA: coronal shearing force
IIB: sagittal shearing force
IIC: horizontal shearing force

III:Fracture of posterior tubercle
IV: Fracture of the lateral process
V: crush fracture

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20
Q

Lateral Talar process fracture

A

Hawkins
Type I: simple fracture of the lateral process that extends from the talofibular articular surface down to the posterior talocalcaneal articular surface of the STJ
Type II: comminuted fracture of tht elateral process that involves both fibular and posterior calcaneal articular surfaces of the talus and entire lateral process
Type III: chip fracture of the anterior and inferior portion of the posterior articular process of talus

21
Q

Calcaneal Fractures

A

Rowe, Sanders and Essex-Lopresti

22
Q

Rowe Type I

A

A: fracture of the tuberosity due to inverted or everted foot
B: Fracture of the sustentaculum tali due to twist on supinated foot
C: fracture of the anterior tubercle due to plantarflexion on a supinated foot

23
Q

Rowe Type II

A

A: Beak fracture without Achilles insertion involvement
B: Avulsion fracture of the Achilles tendon

24
Q

Rowe type III

A

Fracture of the body without STJ involvement

25
Q

Rowe Type IV

A

Fracture of the body with STJ involvement

26
Q

Rowe Type V

A

comminution of the body of the calcaneus

27
Q

Essex Lopresti

A 
Type I (Tongue type): primary fracture line running superior to inferior with secondary fracture line exiting the posterior aspect of the calcaneus
Type II (joint depression): primary fracture line running superior to inferior and secondary line srring the STJ
28
Q

Sanders

A

A-lateral B- Middle C-Sustentaculum tali

I: all non displaced fractures no matter how many fragments
II: 2 part fracture of the posterior facet
III: 3 part fracture of the posterior facet
IV: 4 part fracture with high degree of comminution

29
Q

Navicular fractures

A 
Watson and Jones
I: Fracture of tuberosity
II: fracture of dorsal lip (most common)
III: fracture through body
IIIA: without displacement
IIIB: with displacement
IV: Stress fracture
30
Q

Cuboid fractures (2 types)

A 
1) Body fractures
I: Stress fracture
II: Avulsion      A-bifurcate       B-tarsometatarsal 
III: body fracture non-displaced
IV: Indirect crush
V: plantar dislocation
VI: direct crush

2) avulsion fractures

31
Q

Cuneiforms (2 types)

A 
1)body fractures
I:simple
II: comminuted or crushed 
III: fracture with dislocation
IV: osteochondral
2)Avulsion fractures: usually due to TA
32
Q

5th met fractures (2 types)

A

Stewart and Torg

33
Q

Stewart classification

A

Type I: True Jones fracture at the metaphysis of the 5th base

Type II: Intra-articular fracture of the base of the 5th met resulting from contraction of the peroneus brevis

Type III: avulsion fracture of the 5th met

Type IV: comminuted intra-articular fracture of the base of the 5th

Type V: partial avulsion fracture of the epiphysis have of risk of Iselin’s AVN with this type of fracture

34
Q

Torg

A

I: Acute jones fracture
II: Delayed union of a Jones fracture
III: Non-union of a Jones fracture

35
Q

Wagner Classification

A

Grade 0: No open lesions in the skin, bony prominence and structural deformity present

Grade 1: Superficial ulcer without deep penetration to deep layers

Grade2: deep ulceration penetrating to tendon, bone, joint capsule, or ligament
Grade 3: grade 2 ulcer with presence of infection

Grade 4: gangrene of the forefoot

Grade 5: gangrene of the entire foot

36
Q

USATHC

A

Grade 0: pre or post ulcerative lesion completely epithelialized
Grade 1: superficial wound not involving tendon, capsule or bone
Grade 2: wound penetrating to tendon or capsule
Grade 3: wound penetrating bone or joint

A: non-ischemic, clean wound
B: infected wound
C: ischemic wound
D: both infected and ischemic

37
Q

Charcot classification

A

Eichenholtz
1) Development: acute destructive period distinguished by joint effusion, subluxation, edema, formation of bone and cartilage debris and intra-articular fractures

2) Coalescence: lessening of edema, absorption of debris and healing of fractures
3) Reconstruction: further repair and remodeling of bone to restore stability

38
Q

Nerve injuries

A

Sedden and sunderland

39
Q

Sedden Classification

A

1)Neuropraxia: interruption of nerve impulses due to external nerve pressure resulting in pinpoint segmental demyelination

2 Axonotomesis: severance of individual nerve fibers resulting in partial or complete severance of the nerve

3) Neurotomesis: Complete severance of the nerve resulting in Wallerian degeneration

40
Q

Sunderland

A

1st degree: Disruption of neurological impulses without Wallerian degeneration

2nd degree: disruption of the axon with Wallerian degeneration distal to the point of trauma

3rd degree: fibrous and obstruction of the nerve, regrowth with fusiform swelling

4th degree: incomplete severance of the nerve

5th degree: complete severance of the nerve

41
Q

Osteomyelitis

A

Buckholz

Type I: Wound induced ostomyelitis
IA: Open fracture with complete incontinuity
IB: Penetrating wound
IC: Post op infections

Type II: Mechanogenic osteomyelitis
IIA: implants and internal fixation
IIB: Contact instability as bone to bone appositional movement

III: physeal osteomyelitis

IV: ischemic osteomyelitis

V: combination osteomyelitis, types 1-4 as acute bone infections

VI: Osteitis with septic arthritis

VII: Chronic osteomyelitis

42
Q

2 classes of tarsal coalitions

A

Bridge: Intra-articular coalition that occurs at a normal joint
Bar: extra-articular coalition that occurs outside a normal joint

43
Q

Downey (juvenile classification)

A

Type I: Extra-articular
A:No secondary arthritis (Badgley procedure)
B: Secondary arthritis (resection, triple)

Type II: Intra-articular
A: No secondary arthritis (resection, isolated arthrodesis, triple)
B: Secondary arthrodesis (triple)

44
Q

Downey (adult classification)

A

Type I: Extra-articular
A: no secondary arthritis (resection, triple)
B: secondary arthritis (triple)

Type II: Intra-articular
A: no secondary arthritis (isolated, triple)
B: Secondary arthritis (triple)

45
Q

Malignant melanoma (2)

A

Clark (based on level of invasion)

Breslow (based on thickness)

46
Q

Clark

A

Level of invasion
Level 1: located in epidermis or epidermal-dermal junction
Level 2: located in papillary dermis
Level 3: located in papillary to reticular dermis
Level 4: located down into the reticular dermis
Level 5: located within the subcutaneous tissue

47
Q

Breslow

A

Based on Thickness of the melanoma

Level 1: 4 cm

48
Q

Hallux Limitus

A

Oloff and Jacobs

Grade I: pre-hallux limitus with metatarsus primus elevatus, plantar subluxation of the proximal phalanx on 1st met head. Pain with end ROM, deformity is functional in nature.

Grade II: Some flattening of met head with a possible osteochondral defect, pain on end ROM and structureal adaptation has occured. Passive ROM is limited

Grade III: More severe flattening of met head, osteophytic production and large dorsal exostosis on proximal phalanx and met head. Non-uniform narrowing of joint space, crepitus and pain on full ROM

Grade IV: more sever form of grade 3 with obliteration of the joint space, loose bodies present in the joint space or capsule, <10 degrees of total MTPJ motion

General Classifications (1 decks)

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