The Qualifications

The qualifications are becoming increasingly more important for the thorough understanding of the different fractures and in particular for the classification of the pelvic and spinal fractures. It is for this reason that in the new format of the CCF they have come to play a much more important role. They are particularly important in research where minute detail is of importance.

Sometimes an extra level of precision in defining the subgroups is necessary. Previously the surgeon had to describe in long hand the various qualifications of the fracture. In the new system we have evolved, the surgeon simply identifies the appropriate qualification by a number from 1 to 9 and enters this number in parentheses directly following the number denoting the subgroup. In the qualifications numbered from 1 to 6, the first code number listed in parentheses conveys additional information about the fracture location and extent and the second adds more descriptive information. Three additional qualifications remain: 7) represents a partial amputation, 8) a total amputation, and 9) a loss of bony substance.

The qualifications are used more commonly in conjunction with the Subgroups to expand on the details of the diagnosis. They can be used, however, with the fracture Groups and even fracture Types. If they are used in conjunction with a fracture Group, then they qualify all the Subgroups of this Group. Similarly, if they are used in conjunction with a fracture Type, then they qualify all the Groups and Subgroups of this fracture Type. For instance, in fractures of the distal radius and ulna, in all partial articular (= Type B) and complete articular (= Type C) fractures, it is important to indicate whether there is an associated lesion of the distal radio-ulnar joint or not.