Classifications

Question 1

Classification of congenital nevi.

Answer 1

Small: < 1.5cm^2
Medium: 1.5 - 20cm^2
Giant: > 20 cm^2
Other cut-offs for ‘giant’ include > 1% TBSA or > size of the palm of the hand.

Question 2

Classification of malocclusion

Answer 2

Classification based on the maxillary first molar. In cases where the first molar is missing, canine teeth are used.

ANGLE Class I | NEUTROOCCLUSION: The mesiobuccal cusp of the maxillary first permanent molar occludes with the mesiobuccal groove of the mandibular first permanent molar.

ANGLE Class II | DISTOOCCLUSION (overjet): The molar relationship shows the mesiobuccal groove of the mandibular first molar is DISTALLY (posteriorly) positioned when in occlusion with the mesiobuccal cusp of the maxillary first molar.

ANGLE Class III | MESIOOCCLUSION (negative overjet): The mesiobuccal cusp of the maxillary first permanent molar occludes DISTALLY(posteriorly) to the mesiobuccal groove of the mandibular first molar.

Question 3

Classification of midface fractures.

Answer 3

LeFort I:

Seperates tooth-bear maxilla from midface.
Extends from the piriform aperature posteriorly through the nasal septum, lateral nasal walls, anterior maxillary wall, through the maxillary tuberosity or pterygoid plates.
Upper jaw clinically mobile.
LeFort II:

Extends through the frontonasal junction along medial orbital wall, usually passing through inferior orbital rim at ZM, continues posteriorly through tuberosity or pterygoid paltes.
Upper jaw and nasal bones clinically mobile as a single unit.
LeFort III:

Craniofacial disjunction
Extends through frontonasal junction along medial orbital wall and inferior orbital fissure and out lateral orbital wall.
Complete separation of the midface at the level of the NOE and the ZF.

Question 4

Classification of brachial plexus injury (level).

Answer 4

Level 1: Inside the (vertebral) bone (preganglionic root) injury, including spinal cord, rootlet, and root injury.

Level 2: Inside the (scalene) muscle (postganglionic spinal nerve) injury, located at the interscalene space proximal to the suprascapular nerve.

Level 3: Pre- and retroclavicular injury, including trunks and divisions.

Level 4: Infraclavicular injury, including cords and terminal branch injury proximal to the axillary fossa.

Question 5

Classification of nasoorbital ethoid (NOE) fractures.

Answer 5

Manson-Markowitz classification.

Type I: A single, non-comminuted, central fragment without medial canthal tendon disruption.
Type II: Comminuted central fragment without medial canthal tendon disruption.
Type III: Severely comminuted central fragment with disruption of the medial canthal tendon.

Question 6

What is the Pairolero classification

Answer 6

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Question 6

What is the classification for pressure ulcers

Answer 6

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Question 7

Describe the Veau classification

Question 8

Describe Wassel classification

Answer 8

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Question 9

Describe the Eaton and Littler classification

Answer 9

Eaton and Littler Classification of Basilar Thumb Arthritis

Stage I: Subtle carpometacarpal joint space widening.

Stage II: Slight carpometacarpal joint space narrowing, sclerosis, and cystic changes with osteophytes or loose bodies < 2 mm.

Stage III: Advanced carpometacarpal joint space narrowing, sclerosis, and cystic changes with osteophytes or loose bodies > 2 mm.

Stage IV: Arthritic changes in the carpometacarpal joint as in Stage III with scaphotrapezial arthritis.

Question 10

Describe the Hastings classification

Answer 10

Kiefhaber modification of Hastings classification dorsal PIP Fracture-Dislocations.

Type I - Stable fracture-dislocation: Less than 30% articular base of middle phalanx Congruent through full range of motion

Type II - Tenuous: 30% to 50% articular base of middle phalanx, reduces with less than 30 degrees flexion

Type III - Unstable: Mote than 50% of A-P diameter or less than 50% but requires more than 30 degrees PIP flexion to maintain reduction.

Question 11

Describe the Kernahan and Stark classification

Answer 11

Cleft lip and palate
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Question 12

Describe the Watson classification

Answer 12

Watson Classication of Scapholunate Advanced Collapse (SLAC).

Stage I: Arthritis between scaphoid and radial styloid

Stage II: Arthritis between scaphoid and entire scaphoid facet of the radius

Stage III: Arthritis between capitate and lunate

Question 13

Describe the Clark stages of melanoma

Answer 13

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Question 14

What are the different types of CRPS

Answer 14

CRPS type I: Causation by an initiating noxious event, such as a crush or soft tissue injury; or by immobilization, such as a tight cast or frozen shoulder. No nerve injury.

CRPS Type II: Presence of a defined nerve injury.

Question 15

Describe the Fitzpatrick classification

Answer 15

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Question 16

Describe the Schobinger stages

Answer 16

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Question 17

Describe the Salter-Harris classification

Answer 17

1: Straight across GP
2: Above growth plate
3: beLow growth plate
4: Through GP
5: ERasure of GP/impaction GP

Question 18

Describe the Glogau classification

Answer 18

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Question 19

Describe the Blauth classification

Answer 19

Thumb hypoplasia
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Question 20

Describe the Stranc and Robertson classification

Answer 20

Stranc and Robertson classification of nasal bone fractures.

Fractures are described as “Frontal” or “Lateral” depending on the direction of the force sustained, and based on the ‘plane’ based on the degree of the fracture.

Plane I: The caudal end of the nasal bones and the septum are injured.

Plane II: The entire caudal end of the nasal bones as well as the frontal process of the maxilla at the piriform aperture and the septum.

Plane III: The nasal bones are fractured and extend to the frontal bone as well as one or both frontal processes of the maxilla extending the orbital rim. These are NOE fractures.

Question 21

Describe the Kellgren and Lawrence classification

Answer 21

Kellgren and Lawrence classification of osteoarthritis.

Grade 0: no radiographic features of OA are present

Grade 1: doubtful joint space narrowing (JSN) and possible osteophytic lipping

Grade 2: definite osteophytes and possible JSN on anteroposterior weight-bearing radiograph

Grade 3: multiple osteophytes, definite JSN, sclerosis, possible bony deformity

Grade 4: large osteophytes, marked JSN, severe sclerosis and definite bony deformity

Question 22

Describe the classification of vaginal defects

Answer 22

Classification of vaginal defects.

Type I: Partial defect.

> Type Ia: Anterior or lateral wall. Partial defect.

> Type Ib: Posterior wall. Partial defect.

Type II: Circumferential defect.

> Type IIa: Upper two-thirds. Circumferential defect.

> Type IIb: Total vaginal defect. Circumferential defect.

Question 23

Describe the Schobinger classification

Answer 23

Schobinger classification of ateriovenous malformations.

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Question 24

Describe the Vender classification

Answer 24

Watson classification of SLAC often used for classification of the Scaphoid Non-Union Advanced Collapse (SNAC). Vender classification is specific to Scaphoid Non-Union Advanced Collapse (SNAC). Stage I: Interface between the radius scaphoid fossa and the fractured scaphoid distal fragment interface is affected. Stage II: Interface between the fractured scaphoid proximal fragment and capitate is also affected. Stage III: Radius-scaphoid, scaphoid-capitate and lunate-capitate interfaces are affected.

Question 25

Describe the Gustillo classification

Answer 25

Lower extremity injuries Add

Question 26

Describe Doyle's classification

Answer 26

Doyle’s Classification of Mallet Finger injuries. Type I: Closed injury with or without small dorsal avulusion fracture. Type II: Open injury (laceration). Type III: Open injury (deep soft tissue abrasion involving loss skin and tendon substance). Type IV: Mallet fracture *A:** distal phalanx physeal injury (pediatrics) *B:** fracture fragment involving 20% to 50% of articular surface (adult) *C:** fracture fragment >50% of articular surface (adult)

Question 27

Describe the Hurley Stages

Answer 27

Hurley Stages of Lesions in Hidradenitis Suppurativa. Stage I: Localized and includes the formation of single or multiple abscesses, without sinus tracts and scarring. Stage II: Characterized by recurrent abscesses, with sinus tract formation and scarring, occurring as either single lesions or multiple, widely separated lesions Stage III: disease, which includes diffuse or nearly diffuse involvement of the affected region, with multiple interconnected tracts and abscesses across the entire area.

Question 28

Describe the classification of muscle sparing TRAM.

Answer 28

MS-0: No muscle spared. MS-1: Lateral muscle spared. MS-2: Medial and lateral muscle spared. MS-3: All muscle spared.

Question 29

Describe the Huger / Nahai classification

Answer 29

Huger / Nahai classification of abdominal vascular zones: Zone 1 – Xyphoid & costal cartilage to line between ASIS, overlying rectus abdominus (Superior & Inferior Epigastric vessels) Zone 2 – inferior to line between ASIS to the pubis and inguinal crease (circumflex iliac & external pudendal) Zone 3 – Lateral to zone 1 and superior to zone 2 (intercostal and lumbar vessels – travel between IO & TA)

Question 30

Classification system for labial protrusion

Answer 30

Classification system for labial protrusion based on the distance of the lateral edge of the labia minora from that of the labia majora (Motakef et al.): Class I: 0 - 2 cm Class II: 2 - 4 cm Class III: >4 cm * An “A” is added for asymmetry and a “C” for involvement of the clitoral hood

Question 31

Describe the Nagata classification

Answer 31

Anotia: Absence of auricular tissue. Lobular type: Remnant ear. Lobule and helix present. Concha, acoustic meatus, and tragus absent. Conchal type: Remnant ear. Lobule, concha, acoustis meatus, tragus present. Small conchal type: Remnant ear. Lobule + small indentation of concha present. Atpical microtia: Cases that do not fit into other categories.

Question 32

Describe the classification of Lymphedema.

Answer 32

Stage 0: Latent or subclinical. No edema evident, but lymph transport impaired. Can occur months or years before overt edema. Stage I: Early accumulation of proteinaceous fluid with edema that resolves with limb elevation. Pitting edema can occur. Stage II: Pitting edema may or may not be present. Tissue fibrosis develops. Does not resolve with limb elevation. Stage III: Lymphostatic elephantiasis with absent pitting. Acanthosis, fat deposits, warty growth, and other trophic skin changes.

Question 33

Describe the classification of camptodactyly.

Answer 33

Type 1: Apparent during infancy, usually isolated to the small finger. Type 2: Develops during preadolescence and may progress rapidly during growth. Type 3: Severe, involves multiple digits, and is part of a syndrome (most commonly arthrogryposis)

Question 34

Describe the Pairolero and Arnold classification

Answer 34

Pairolero and Arnold classification of sternal wounds: Type 1: Serosanguineous drainage within first 3 days, negative cultures, no cellulitis or osteomyeltitis. Tx: Reexplore, debride, reclose. Type 2: Purulent mediastinitis occurring within first 3 weeks, positive cultures, and cellulitis and/or osteomyeltitis. Tx: Reexplore, debride, flap. Type 3: Draining sinus tract from chronic osteomyelitis months to years after procedure. Tx: Reexplore, debride, flap.

Question 35

Describe the Starzynski classification

Answer 35

Loss of upper sternal body and adjacent ribs (physiological deficit: minimal) Loss of entire sternal body and adjacent ribs (physiological deficit: moderate) Loss of manubrium and upper sternal body with adjacent ribs (physiological deficit: severe)

Question 36

Describe the zones of Guyon’s canal.

Answer 36

Zone I: Proximal to the ulnar nerve bifurcation. Zone II: surrounds the ulnar nerve deep motor branch as it passes the hamate hook. Zone III: surrounds the ulnar nerve sensory branch.

Question 37

Describe the levels of axillary lymph nodes.

Answer 37

Level I: Lateral to the lateral border of pectoralis minor. Level II: Behind pectoralis minor and below axillaru vein. Level III: Medial to medial border of pectoralis minor.

Question 38

Describe the Baker classification

Answer 38

Capsular contracture Grade I: No palpable capsule. The augmented breast feels as soft as an unoperated breast. Grade II: Minimal firmness. Breast is less soft, and the implant can be palpated but not visible. Grade III: Moderate firmness. The breast is harder, the implant can be palpated easily and it can be seen. Grade IV: Severe contracture. The breast is hard and tender. Associated with pain.

Question 39

Describe the Von Heimburg classification

Answer 39

Type I. Hypoplasia of the lower medial quadrant. Type II. Hypoplasia of the lower medial and lateral quadrants, sufficient skin in the subareolar region. Type III. Hypoplasia of the lower medial and lateral quadrants, deficiency of skin in the subareolar region. Type IV. Severe breast constriction, minimal breast base.

Question 40

Describe the Huger classification

Answer 40

Zone I: Bounded superiorly by the costal margin, laterally by the lateral borders of the rectus sheath, and inferiorly by a line drawn between the ASIS bilaterally. Supplied primarily by superficial branches of the superior and inferior epigastric systems. Zone II: Bounded superiorly by a line connecting the bilateral ASIS and laterally/inferiorly by the inguinal creases. Supplied by the superficial branches of the circumflex iliac and external pudenal vessels. Zone III: Superior to Zone II and lateral to Zone I. Supplied by the intercostals, subcostals, and lumbar vessels.

Question 41

Describe the Felicio classification

Answer 41

Felicio classification of labia minora enlargement. Type I: < 2cm Type II: 2-4 cm Type III: 4-6cm Type IV: >6cm

Question 42

Classifcation of upper arm contouring

Answer 42

Type i: Minimal skin excess with moderate fat excess. Type II: Moderate skin excess with minimal fat excess. Type III: Moderate skin excess with moderate fat excess. ** Subgroups defined by location of SKIN excess ***

Question 43

Describe the Upton classification (Upton)

Answer 43

Type I: Macrodactyly with lipofibromatosis of nerve Type II: Macrodactyly associated with neurofibromatosis(von Recklinghausen’s disease) Type III: Macrodactyly with hyperostosis(excessive bone growth) Type IV: Macrodactyly with hemihypertrophy

Question 44

Describe the classification of CENTRAL LONGITUDINAL DEFICIENCY

Answer 44

Classification largely based on degree of first webspace deficiency. Type 1: Normale first web space. Type 2a: MIldly narroweb web space. Type 2b: Severely narrowed web space. Type 3: Thumb/index syndactyly Type 4: Index raw supressed, thumb web space merged with cleft. Type 5: Thumb elements supressed.

Question 45

Classification of nail bed injury

Answer 45

1: Small(25%) subungeal hematoma 2: Larger (50%) subungeal hematoma 3: Nail bed laceration with P3 Fx 4: Nail bed fragmentation 5: Nail bed avulsion

Question 46

Classification for Jersey finger avulsion

Answer 46

Leddy and Packer Type 1: FDP retract into palm, disruption of both vincula Type 2: FDP retracts to level of PIP, held by intact vincula Type 3: FDP avulses with large bony fragment, held by A4 pulley Type 4: Fracture of P3 base + avulsion of the tendon from the bony fragment

Question 47

Classification of sagital band injuries

Answer 47

Type 1: injury without stability Type 2: Injury with tendon subluxation Type 3: Injury with tendon dislocation

Question 48

Medical Research Council Muscle Scale

Answer 48

0: no contraction 1: Flicker or trace of contraction 2: Active movement, with gravity eliminated 3: Active movement, against gravity 4: Active movement, against gravity with resistance 5: Normal power

Question 49

Palmar classe 1 pour TFCC aigu

Answer 49

1A: central 1B: ulnaire 1C: distal 1D: radial

Question 50

Palmar classe 2 pour TFCC dégénératif

Answer 50

2A: usure et amincissement TFCC 2B: 2A+ chrondromalacie lunate 2C: 2B + Perfo TFCC 2D: 2C + rupture ligamentaire 2E: 2D + arthrite ulnocarpienne et DRUJ