History

The Comprehensive Classification of Fractures (CCF) was developed between 1977 and 1987. It is based on the AO/ASIF Documentation of operatively treated fractures which the AO/ASIF initiated in 1959.

The AO/ASIF Documentation consists of over 150,000 fully documented fracture cases together with their miniaturized X-rays taken at the time of the initial presentation, immediately after surgery, and then at 4 and 12 months follow-up.

Format of classification 1980. The hierarchically organized 3 triads.

In 1987, the SICOT Presidential Commission for Documentation and Evaluation, chaired by Professor Maurice E. Müller, began its work and soon thereafter the Commission published its modification of the AO/ASIF classification. This publication was in a pamphlet format folded in such a way that it could be carried about in a pocket for ready reference. "The Comprehensive Classification of Fractures of Long Bones" was published in 1990 at the time of the SICOT Congress which was held in Montreal.

Once the Comprehensive Classification came into daily use by the surgeons, we became aware of certain shortcomings. A serious problem was the fact that quite frequently surgeons encountered considerable difficulty in classifying a fracture. One of the problems was the hierarchical division of fractures into triads with 27 fractures in each segment of a long bone. This was far too much detail for anyone to memorize. To overcome this difficulty we have developed a binary system of questions described in detail in both pamphlets. This system relies on a logical progression of questions leading one to the correct answer rather than on shear memory.

Format of CCF 1996. The development of the first 2 triads (Type and Group) with the help of the binary system.