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How to Use the Classification 1) When classifying a fracture, the first thing to do is to define the bone or group of bones and then the segment. In the X-ray that serves as an example: segment 23 = distal radius and ulna. 2) Once the segment
is determined, one proceeds to define the Type and Group of the fracture.
To do this, one has to choose between one or two possibilities out of
two to four options. The choice 1a) for segment 23 is: Is this an articular
or an extra-articular fracture? If the fracture is extra-articular
one proceeds directly to define the Group. When the fracture is intra-articular,
like in this case, one goes on to the choice 1b): Is this a partial
articular fracture = Type B, or a complete articular fracture
= Type C? 3) The process to define the Group within Type C is quite similar. The second question with two options is: Is the articular fracture simple or multifragmentary ? The fracture selected for the radiographical example is a C3 fracture = complete articular, multifragmentary. It is the most severe fracture of Type C , the most difficult one. 4) There are three possible choices to define the Subgroup. Metaphyseal multifragmentary is the correct choice according to the Heim´s square rule, which locates the fracture in the distal segment of the radius and ulna.
Binary system for
type and group (the correct answer is in bold type):
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