Fundación Maurice E. Müller - España
Foundation Overview Teaching Activities and ServicesComprehensive Classification SystemBooksData Base of Fractures CasesResearch ActivitiesWebsite Map
Atlas of International Fixation Errores en la OsteosíntesisAtlas de Artroscopia
Introduction Presentation Explanation Main Index Collaborations

Foreword Preface to the English Edition Preface to the Spanish Edition
Presentation Acknowledgements The Classification
Principles of the Classification Colors and Glossary Bones and Segments Types Exceptions to the Types How to Use the Classification
Statistical Abstract References

Bones and Segments

The classification is of alphanumeric nature. The numbers 1 to 4 are used to identify the long bones. Each bone is divided into three segments numbered 1 to 3. The malleoli are an exception and form segment 4.

The anatomic delimitation of the segments, proximal and distal, and of the diaphysis in between, is performed according to the arbitrary method proposed by Urs Heim. It is easy to apply to a radiograph and quite useful clinically. The formula is: the proximal and distal segments of each bone (with the exception of the proximal femur) are delimited by a square whose lateral sides are parallel to the axis of the bone and their lenght equal to the maximum width of the epiphysis. This is “Heim´s square”.

When a fracture line involves two segments, to determine the segment to which the fracture belongs one must find the center of the fracture and that point defines the segment. When one diaphyseal or metaphyseal fracture line extends significantly to involve the joint, the fracture is classified always as the most severe one (the articular) and it is identified with its corresponding epiphyseal segment.