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Introduction Explanation Trainning Tool Hall of Fame

History Introduction Principle Anatomic Location
The 3 Fracture "Types" of Long Bones The Coding of the Diagnosis
The Qualifications How to use this Classification Glossary References

How to use this Classification

This is the procedure how to use this classification:

  1. In localizing a fracture, one must first of all establish the bone or group of bones and then the bone segment. In our example segment 23- = Radius/Ulna distal.

  2. Once the segment is determined, one can proceed to determine the fracture Type and Group from one or two choices between 2-4 options.The choice 1a) for the segment 23- is: "Is the fracture extra-articular or articular?". If the fracture is extra-articular, one can proceed directly to the determination of the fracture Group. If the fracture is intra-articular like in our case, then one goes on the choice 1b): "Is the fracture partial articular = Type B, or complete articular = Type C?". For the exact definition of extra-articular, partial and complete articular please consult the Glossary.

  3. We proceed in a very similar way to determine the Group of Type C. The second question with 2 options is: "Is the fracture articular simple or articular multifragmentary?" (for definition see Glossary). The fracture we have chosen in the X-ray example is certainly a C3-fracture = complete articular fx, articular multifragmentary. This is the most severe fracture of the in itself difficult Type C.

  4. There are three possibilities to choose from in determining the Subgroup. "Metaphyseal multifragmentary" is certainly the correct choice according to the rule of squares which localizes the fracture to the distal segment of the radius/ulna.

  5. In order to denote the associated lesion of the distal radio-ulnar joint, we must resort to the Qualifications. In the picture we can see that the radio-ulnar joint is disrupted and the styloid process of the ulna fractured. Full diagnosis at the bottom.

X-ray (case) example on the left.

Binary questioning or for Type and Group (correct answer underlined):
Type: Choice between 2-4 options
  1. fx. extra-articular or articular?... = B/C
  2. partial articular or complete articular?... = C
Group: Choice between 2 options
articular simple or articular multifragmentary ?   = C3

Subgroup: Choice between 3 possible answers
  1. metaphyseal simple? (No)
  2. metaphyseal multifragmentary?... Yes = C3.2
  3. extending into the diaphysis? (No)
Q: Add Qualifications of Subgroup C3.2 in order to know the associated lesion of the radio-ulnar joint.