Classifications Flashcards by Jonathan Negus

Classification of Galleazzi fractures

Walsh JBJSBr 1987
Type 1 - volar apex and volar dislocation - supination injury
Type 2 - dorsal and dorsal. Probation injury

How well did you know this?

Not at all

Perfectly

Classification of Monteggia fractures

Badot
Type 1 - apex anterior with anterior dislocation
Type 2 - apex posterior with posterior dislocation
Type 3 - apex lateral with lateral dislocation
Type 4 - any direction fracture with proximal ulna and radial head fracture-dislocation

How well did you know this?

Not at all

Perfectly

Classification of Bipartite patella

Saupe classification

Type 1 - inferior pole 5%
Type 2 - lateral pole 20%
Type 3 - superolateral 75%

Saupe H, Deutshe Z Chir 1943;258:386

How well did you know this?

Not at all

Perfectly

Classification of Paediatric hip fracture

Delbet

Type 1 - transepiphyseal 10% (AVN 100%)
Type 2 - transcervical. 50% (AVN 50%)
Type 3 - cervicoteochanteric 30% (AVN 25%)
Type 4 - inter trochanteric 10% (AVN 10%)

Type 1 - 50% dislocations. THINK NAI

How well did you know this?

Not at all

Perfectly

Classification of infantile Blount’s

Langenskiold

1 beaked Metaphysis
2 saucer shaped defect
3 stepped defect
4 bent physeal plate
5 double epiphysis
6 physeal bar

How well did you know this?

Not at all

Perfectly

Classification of acromial fractures

Kuhn

1 - non displaced or minimally displaced
2 - Displaced but does not compromise the subacromial space
3 - Displaced but compromises the subacromial space

How well did you know this?

Not at all

Perfectly

Classification of scapula fractures

Ada and Miller

1a - acromial
1b - scapular spine
1c - coracoid

2a - glenoid neck
2b - glenoid neck
2c - glenoid neck

3 glenoid fractures

4 body fractures

How well did you know this?

Not at all

Perfectly

Classification of glenoid fractures

Mayo modification of Ideburg classification

1- ant/inferior -bankart
2- superior 1/3 to 1/2 displaced articular in continuity with coracoid
3- inferior 1/2 extending to lateral border
4- inferior articular surface extending to body
5- type 4 plus coracoid, acromial or free superior articular component

How well did you know this?

Not at all

Perfectly

What are the classifications used for LCP disease - Perthes

Herring - lateral pillar height
Group A - no involvement lateral pillar
Group B - >50% maintained LP height
Group B/C 50% maintained LP height
Group C -

How well did you know this?

Not at all

Perfectly

At risk signs for perthes - Catterall

Gage sign / radiolucency in shape of V in lateral epiphysis

Calcification lateral to epiphysis

Laterally subluxed femoral head

Horizontal physis

How well did you know this?

Not at all

Perfectly

Late changes of Perthes in proximal femur and head shape

Coxa breva
Coxa Magna
Coxa plana
Coxa vara
Sagging rope sign
GT overgrowth
Shortening

How well did you know this?

Not at all

Perfectly

Classification of perilunate instability

Mayfield

1 - scapholunate ligament
2 - SL and LC
3 - SL and LC and LT - dorsal perilunate dislocation
4 - volar lunate dislocation

Fracture - trans’bone’ perilunate dislocation

How well did you know this?

Not at all

Perfectly

Classification of Hamatometacarpal fracture dislocation

Cain

1a - ligamentous - stable-cast, unstable -CRPP
1b - dorsal hamate fracture - stable-cast, unstable - ORIF
2 - comminuted dorsal hamate. -ORIF to restore dorsal buttress
3 - coronal hamate fracture - ORIF to restore congruent joint surface

CRPP - CR with per cutaneous pinning

How well did you know this?

Not at all

Perfectly

Causes of Erlenmeyer flask deformity

C - cranio Metaphyseal dysplasia 
H - Haemoglobinopathies - sickle
O - OI
N - Niemann  pick
G - Gauchers

M - MPS
M - MHE
M - metal poisoning

Pyles
Lead poisoning

How well did you know this?

Not at all

Perfectly

Classification of navicular fractures

Tuberosity
Avulsion
Stress
Body

Sangeorzan

Type 1 - transverse
Type 2 - oblique
type 3 - central

Poor central blood supply
Undisplaced - non-op
Displaced - ORIF

How well did you know this?

Not at all

Perfectly

Classify paediatric pelvis fractures

Torode and Zieg

1- avulsion
2- iliac wing
3- simple ring
4- disrupted ring

Tile
A- stable vertically and rotational 
A1 not involving the ring
A2 involving the ring
B- vertically stable but rotational unstable
B1 open book
B2 lateral compression/ipsilateral
B3 lateral compression/contra lateral
C- unstable in both 
Unilateral/bilateral/associated with acetabular fracture

Young and Burgess
Lat compression 
 LC1- sacral on side of impact
 LC2- crescent on side of impact
 LC3- 1or2 with contralateral open book
AP Compression
 APC1- minor opening symphysis and anterior SI
APC2- opening anterior SIJ and intact posterior SIJ
APC3- complete SIJ
VS - vertical shear
CM - combined mechanism

How well did you know this?

Not at all

Perfectly

What is the classification of soft tissues for fractures.

Tscherne

Grade 0 - 
1
2
3
4

How well did you know this?

Not at all

Perfectly

What is the classification of pilon fractures

Ruedi-Allgower

1- undisplaced
2- displaced / minimally comminuted
3- displaced / highly comminuted

How well did you know this?

Not at all

Perfectly

What is the MESS score

Age 0,1,2
BP 0,1,2
Circulation 1,2,3 (x2)
Degree of injury 1,2,3,4

Critic
Score is 7
>=7 amputation
50
BP always >90, transiently hypotensive, persistent
Normal perfusion, pulse less decreased cap refill, cool paralysed insensate (x2 >6 hours ischaemia)
Low energy, medium, high, very high

What is classification of acetabular fractures?

Judet & Letournel

Elementary
1-posterior wall
2-posterior column
3-anterior wall
4-anterior column 
5-transverse - trans, juxtra, infra-tectal 
Associated
1-PW &amp; PC
2-PW &amp; transverse
3-AC &amp; hemitransverse
4- T-type
5- both column

What is the classification of trigger finger

Green

1- Palm pain and tenderness A1 pulley
2- catching of digit
3- locking of digit, passively correctable
4- flexed, locked digit

Classification of loosening in THR

Harris

Possibly - incomplete Lucent line >50% at cement-bone interface

Probably - continuous Lucent line at C-B interface

Definitely loose -

subsidence
cement mantle fracture
implant fracture

How do you classify bony defects in a THR

AAOS

Acetabular 
1 - Segmental deficiency 
2 - Cavitatory deficiency (intact A &amp; P columns)
3 - Combined deficiency 
4 - Pelvic discontinuity
5 - Arthrodesis

Femur
1 - Segmental deficiency 
2 - Cavitatory deficiency 
2a - Cavitatory only
2b - Ectasia (femoral expansion)
3 - Combined deficiency 
4 - Malalignment
5 - Stenosis
6 - Femoral discontinuity

Segmental needs Structural BG
Cavitatory needs non-structural BG
P/F discontinuity requires Healing Bone Bridgjng Fixtion

Paprosky
Based on severity of bone loss and ability to obtain cementless fixation
Based on integrity of
Superior migration of hip centre, ischial osteolysis, acetabular teardrop osteolysis, and position of implant relative to Kohler’s line
1) TYPE 1
Rim intact with no significant rim distortion. Columns intact acetabulum hemispherical. Small focal areas contained bone loss. Kohler line not violated. No migration of component and no osteolysis Hemispherical uncemented implant
2) TYPE 2
2a – Columns and rim intact. Bone loss superior and medial. Hip centre migrated superiorly. Migration 3cm migration, moderate ischial lysis and intact Kohler line
Hemispherical cup will have 1/2 circumference
Failed component has migrated superiorly and medially
High risk of pelvic discontinuity – recontruict posterior column.
Massive allograft and revonstruction cages

Classification of Freiburgs

Smilie

1-5
1- pre xray
2- sub chondral collapse dorsal
3- Collapse only plantar left
4- Complete MT head collapse
5- Degenerative OA

Classification of Kienbocks

Lichtmann ``` 1- norm xray or linear fracture 2- lunate sclerosis 3- lunate collapse 3a - Normal carpal height 3b - Decreased carpal height /proximal migration capitate / ring sign 4- pancarpal arthritis ```

Classifications of humeral head AVN

Cruess ``` 1- normal xray. Seen on mri 2- sclerosis and osteopaenia 3- crescent sign 4- flattening and collapse 5- degenerative changes to glenoid ```

What are the classifications for Charcot?

``` Eichenholtz 0- preradiological 1- Fragmentation 2- Coalescence 3- Reconstruction ``` ``` Brodsky 1- TMTJ & IMTJ - mid foot 2- Peritalar 3a- Ankle 3b- calcaneal fracture 4- combination 5- forefoot only ``` Schon Pattern of deformity Complex and no evidence for its use

Classifications for OCD of knee and of ankle

Clanton and Delee for knee Same as - ANKLE Berndt & Harty (X-rays) Gd 1- Stable, not detached/undisplaced Gd 2- Stable, partially detached/undisplaced Gd 3- Unstable, completely detached/undisplaced Gd 4- Unstable, completely detached/displaced (loose) Ferkel- MRI Pritsch - Arthroscopy

What is the classification of peroneal retinaculum tears - peroneal tendon instability

Gd 1- SPR partially elevated off fibula allowing big tendons to sublux Get 2- SPR separates off cartilaginous ridge of lateral malleolus allowing tendons to sublux between SPR and cartilaginous ridge Gd 3- Cortical avulsion of SPR off fibula allowing subluxed tendons to move underneath the cortical fragment Gd 4- SPR torn from calcaneus not fibula

What is. Classification for hallux rigidus?

Coughlin 0- 60 degrees / X-ray norm 1- 40 / dorsal osteophyte 2- 30 / dorsal and lateral or medial o'phyte 3-

What are your classification systems of osteomyelitis?

Acute (sup abscess), chronic (involucrum and sequestrum) Direct or indirect Cierny-Mader staging Anatomical location - 1,2,3,4 Physiological status of host - A, BL, BS, C Anatomic - medullary, superficial, localised, diffuse Status - normal, local, systemic, treatment worse than infection

Classification of HO at the knee

Rader 1- lesion 5cm in one location 3- lesion >5cm in 2 locations

Classification of Supracondylar periprosthetic knee fractures

Rorabeck and Lewis 1999 Type 1 - non-displaced and stable Type 2 - displaced and stable Type 3 - unstable - non or displaced SU Type 1 - above level of femoral component Type 2 - at level of Type 3 - Below level

Classification of tibial periprosthetic knee fractures

Felix 1997 Type 1 - tibial plateau Type 2 - adjacent tibial stem Type 3 - distal to stem Type 4 - tibial tubercle

Classification of patella periprosthetic fracture

Goldberg Type 1 - not involving implant or quads Type 2 - involving implant and / or quads Type 3 - - a inferior pole # with patella ligament rupture - b inferior pole # without ligament rupture Type 4 - all types with # dislocations

Classification of OCD at knee

Papas - age at presentation. 1-3. Open to closed physis. ``` Clanton and DeLee - X-rays 1- Stable / not detached / undisplaced 2- partially detached 3- unstable and detached 4- displaced ``` Cahill and Berg Split AP into 5 and lateral into 3. 15 zones 2 c most common

Shoulder arthritis - both OA and CTA

Walch A- concentric, B- eccentric , C- retroverted Seebauer 1- centred a) mild, b) moderate 2- decentred a) severe b) antsup escape

Classification of periprosthetic THR fractures - not bone defects

``` Paprosky 1- Intra op # primary THR 2- intra op # revision THR 3- traumatic # 4- atraumatic # 5- pelvic discontinuity ``` Peterson and Lewallen 1- # associated with clinical and radiological stable component 2- # associated with unstable acetabular component

Classification of Acromion morphology

Bigliani Tyep 1 - Flat 17% Type 2 - Curved 43% Type 3 - Hooked 40%

Classification of stages of RC degeneration

Neer Stage 1 - Oedema and haemorrhage Stage 2 - Fibrosis and tendinitis Stage 3 - Bone spurs and RCT

Classify RC tears by size

Small - 5cm involving 2 or more tendons

Classify RC tears by chronicity

Acute 3 months

Classify RC tears by degree of retraction

Patte CORR 1990 Type 1 - Stump close to bony insertion Type 2 - Stump retraction to level of humeral head Type 3 - Stump retraction to level of glenoid

Classify Partial thickness RC tears

Ellman - Size - 6 Location - A-articular, B-bursal, C- interstitial PASTA - partial articular Supra tendon avulsion PAINT - Partial thickness articular surface intra-tendinous tears Habermayer - Coronal and sagital classifications Tear ranging from cartilage bone transition laterally to GT & From coracohumeral ligament medially to Supra tendon into crescent zone

Classify RC tears by fatty infiltration

``` Goutallier COOR 1984 - CT scans MRI scans is Fuchs & Thomazeau 0 - Normal 1 - fatty streaks 2- 50% ``` Thomazeau - T1 images 1 - Normal or slight atrophy 2 - Moderate 3 - Serious or severe

What is abnormal AHI

Normal range - 7-14mm mean 10.5mm | If