The Classification
S. Nazarian

This atlas follows the same organization as the AO Classification of Fractures of Long Bones by M.E. Müller and co-workers, edited by Springer Verlag in 1987 and adopted by the majority of the international societies of orthopaedic surgery and traumatology. Some years ago, when the Classification was presented, there were many criticisms stating that many of the fracture drawings did not correspond with reality. The atlas furnishes the radiographic proof of their clinical existence.

Characteristics of the Classification

1.It is a comprehensive classification that includes the topography of the lesion according to a rational plan, organized in hierarchical triads that indicate their severity. They are labelled following an alpha-numerical code (three types: A, B, C, divided in three groups: 1, 2, 3, themselves subdivided in three subgroups: 1, 2, 3, that may have added special qualifications).

2. The organization chart of the classification is constructed upon anatomical and pathoanatomical criteria. The ternary subdivision is a very attractive simplification which allows, once the coding of the system is known, the identification of all of fractures with their prognosis

3. It is not an analytical classification but rather a synthetic classification that not only includes the anatomical aspect of the fracture but also simultaneously integrates its topography, complexity, prognosis and therapeutic possibilities. The resultant of all of these parameters is what it is known as severity. The severity is the basis of the organization chart of the classification and of its structure.

4. It is an interactive classification that allows easy identification of the characteristics of the fractures through standardized examinations by means sequential simple questions. The classification is easily integrated to the diagnostic process and leads imperceptibly to the therapeutic decision. The most appropiate treatment is derived from the results obtained after a long prospective study of more than 10 years that was the basis for the classification.

5. The classification is evolutionary because it monitors the therapeutic possibilities of each fracture depending on the state of the art of the surgery in each historical moment of its development, as the classification directly reflects. Any spectacular evolution of the surgical procedures will certainly have an effect on the classification according to the philosophy of Maurice Müller which mantains that a classification must “…serve as a base for the treatment and for the evaluation of its results”.

Through a large iconography of an exceptional quality, this atlas, a book of reference, demonstrates the usefulness of the classification as a working tool for teaching, research and quality control.