Trauma classifications

Question 1

Femoral Head Fractures

Answer 1

Pipkin: 1 below fovea, 2 above fovea, 3 1 or 2 with neck fx, 4 1 or 2 with posterior wall fx.

Question 2

Femoral neck fx

Answer 2

Garden 1: valgus impacted. 2 complete nondisplaced. 3 complete displaced <50%. 4 complete displaced.

Question 3

Femoral neck fx

Answer 3

Pauwels angle: Vertical orientation of fracture line. 1: < 30 degrees, 2 30-50. 3 > 50 deg from horizontal.

Question 4

Subtroch fxs

Answer 4

Russell-Taylor classification: 1: no extension into piriformis fossa. 2: extension into greater troch with involvement of piriformis fossa.

Question 5

Femoral shaft fxs

Answer 5

Winquist and Hansen: 0 no comminution, 1 insignificant comminution, 2 greater than 50% cortical contact. 3: less than 50% cortical contact. 4 segmental fx with no contact between proximal and distal fragments.

Question 6

Acetabular fxs

Answer 6

Primary: AW,PW,AC,PC, T. Associated: PCPW, ACPH, T, ABC, TPW

Question 7

Pelvic ring injuries. APC

Answer 7

Young/Burgess. APC 1. Symph widening < 2.5. 2. > 2.5. Anterior SI disruption, posterior intact. 3: both anterior and posterior.

Question 8

Pelvic ring: LC

Answer 8

LC1: Oblique ramus fx and ipsi sacral ala fx.
2: Rami fx and ipsi post ilium fx dislocation ( crescent fx)
3: Windswept pelvis. Ipsi LC and contra APC.
VS: posterior and superior directed force.

Question 9

Sacral fractures:

Answer 9

Denis: 1 lateral to foramina. 2 through foramina. 3: medial to foramina into spinal canal.

Question 10

Monteggia fx

Answer 10

Bado 1 anterior, 2 posterior, 3 laeral, 4 radial fx as well.

Question 11

Radial head fx

Answer 11

Mason 1 minimally displaced, 2 displaced, 3 displaced and comminuted, 4 radial head fx and elbow dislocation

Question 12

Olecranon fx

Answer 12

Mayo Classification: 1 nondisplaced, 2 displaced stable (1 noncomminuted, b comminuted.) 3 unstable (a and b)

Question 13

Capitellum fxs

Answer 13

Bryan and Morrey: 1 large osseous piece of cap, 2 shear fx of art cartilage, 3 severely comminuted, 4 coronal shear that included trochlea.

Question 14

Proximal Humerus

Answer 14

Neer: 4 parts: greater tuberosity, lesser tuberosity, articular surface, shaft. Separate part if > 1 cm, 45 deg angulation.

Question 15

distal humerus single column

Answer 15

Milch classification: type 1 if not across midline, 2 if it is.

Question 16

Bicolumn fractures

Answer 16

Jupiter classification: 5 major articular fragments: cap/lat troch, lat epi, postlat epi, post troch, med troch/epi

Question 17

Clavicle

Answer 17

Group 1, middle 1/3. 2: lateral 1/3. Type 1 lateral to cc ligs, min displaced (stable.) IIa med to intact con/trap ligs (unstable.) IIb between ruptures conoid and intact trap or lat to both torn(unstable.) III intraart fx of AC (stable.)
Group 3: medial 1/3.

Question 18

Tibial Plateau

Answer 18

Shatzker: 1-lateral split, 2 split depression, 3 depression, 4 medial, 5 bi, 6 split bi.

Question 19

Pilon fx fragments

Answer 19

med mal (deltoid ligament), posterolateral Volkman fragment (PITFL), anterolateral Chaput fragment (AITFL)

Question 20

Talar Neck fxs

Answer 20

1 nondisplaced AVN 0-13%, 2 subtalar dislocation AVN 20-50%, 3 subtalar and tibiotalar 20-100%, 4 subtalar, tibiotalar, talonavic 70-100%

Question 21

Ankle PER

Answer 21

PER 1 med mal, 2 ATFL disruption, 3 high fibula spiral or short oblique fx, 4 PTFL or avulsion of posterior malleolus.

Question 22

Ankle SER

Answer 22

SER 1 ATFL sprain, 2 lateral short oblique fibula fx, 3 PTFL or post mall fx, 4 med mall or deltoid

Question 23

Ankle PAB

Answer 23

PAB 1 med mal, 2 ATFL, 3 lat mal comminuted fx above syndesmosis

Question 24

Ankle SAD

Answer 24

SAD 1 fibula avulsion fx, 2 vertical med mal fx.