股骨骨折分型

BONE: FEMUR (3)Location: Proximal segment (31)

Types:

A. Trochanteric area(31-A)

B. Neck fractures(31-B)C. Head fractures(31-C)

Groups:

Femur, proximal trochanteric (31-A)1. Pertro-3. Intertro-2. Pertro-chanteric simplechantericchanteric(31-A1)(31-A3)multifrag-mentary

(31-A2)

Femur, proximal, neck fracture (31-B)

2. Transcer-1. Subcapital 3. Subcapital

vical(31-B2)with slight with marked

displacementdisplacement(31-B1)(31-B3)

Femur, proximal, head fracture (31-C)

1. Split (31-Cl)3. With neck2. With de-fracturepression

(31-C3)(31-C2)

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Subgroups and Qualifications:

Femur, proximal, pertrochanteric simple (only 2 fragments) (31-A1)

2. Through the greater trochanter 1. Along intertrochanteric line

(31-A1.2)(31-A1.1)

(1) nonimpacted(2) impacted

3. Below lesser trochanter(31-A1.3)(1) high variety, medial fracture line atlower limit of lesser trochanter

(2) low variety, medial fracture line in di-aphysis below lesser trochanter

A1

Femur proximal, trochanteric fracture, pertrochanteric multifragmentary (always have posteromedial fragment with lessertrochanter and adjacent medial cortex) (31-A2)1. With 1 intermediate fragment3. Extending more than 1 cm below2. With several intermediate frag-(31-A2.1)lesser trochanter(31-A2.3)ments(31-A2.2)

A2

Femur, proximal, trochanteric area, intertrochauteric fracture (31-A3)1. Simple oblique(31-A3.1)2. Simple transverse(31-A3.2)

3. Multifragmentary(31-A3.3)

(1) extending to greater trochanter(2) extending to neck

A3

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© 2007 Lippincott Williams & Wilkins

J Orthop Trauma• Volume 21, Number 10 Supplement, November/December 2007Femur

Femur, proximal, neck fracture, slight displacement (31-B1)

1. Impacted in valgus Ն15°

2. Impacted in valgus Ͻ15°(31-B1.1) (Garden 1)

(31-B1.2) (Garden 1/2)(1) posterior tilt Ͻ15°

(1) posterior tilt Ͻ15°(2) posterior tilt Ͼ15°

(2) posterior tilt Ͼ15°B1

Femur, proximal, neck fracture, transcervical (31-B2)

1. Basicervical(31-B2.1)2. Midcervical adduction(31-B2.2)

B2

Femur, proximal, neck fracture, sub-capital, nonimpacted displaced (31-B3)

1. Moderate displacement in varus and 2. Moderate displacement with verti-external rotation(31-B3.1) (Garden 3)cal translation and external rotation

(31-B3.2) (Garden 4)

B3

© 2007 Lippincott Williams & Wilkins

3. Nonimpacted(31-B1.3) (Garden 2)

3. Midcervical shear(31-B2.3)

3. Marked displacement(31-B3.3)(Garden 3/4)(1) in varus

(2) with translation

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Femur, proximal, head fracture, split (31-C1)1. Avulsion of ligamentum teres 2. With rupture of ligamentum teres(31-C1.1)(31-C1.2)

C1

Femur, proximal, head fracture, with depression (31-C2)1. Posterior and superior (31-C2.1)2. Anterior and superior(31-C2.2)

C2

Femur, proximal, head fracture with neck fracture (31-C3)

1. Split and transcervical neck fracture2. Split and subcapital neck fracture

(31-C3.1)

(31-C3.2)C3

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3. Large fragment(31-C1.3)

3. Split depression(31-C2.3)

3. Depression and neck fracture

(31-C3.3)

© 2007 Lippincott Williams & Wilkins

J Orthop Trauma• Volume 21, Number 10 Supplement, November/December 2007Femur

BONE: FEMUR (3)Location: Diaphyseal segment (32)

Types:

A. Simple(32-A)

B. Wedge(32-B)C. Complex(32-C)

Groups:

Femur, diaphyseal, simple fracture (32-A)1. Spiral(32-A1)2. Oblique3. Transverse

(Ն30°)(32-A2)(Ͻ30°)(32-A3)

Femur, diaphyseal, wedge fracture (32-B)1. Spiral wedge2. Bending3. Fragmented(32-B1)wedge (32-B3)wedge(32-B2)Femur, diaphyseal, complex (32-C)

1. Spiral(32-C1)2. Segmental

(32-C2)

3. Irregular(32-C3)

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J Orthop Trauma• Volume 21, Number 10 Supplement, November/December 2007

Subgroups and Qualifications:

Femur, diaphyseal, simple spiral (32-A1)1. Subtrochanteric zone(32-A1.1)

2. Middle zone(32-A1.2)A1

Femur, diaphyseal, simple oblique (Ն30°) (32-A2)1. Subtrochanteric zone(32-A2.1)2. Middle zone(32-A2.2)

A2

Femur, diaphyseal, transverse (Ͻ30°) (32-A3)

1. Subtrochanteric zone(32-A3.1)

2. Middle zone(32-A3.2)A3

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3. Distal zone(32-A1.3)

3. Distal zone(32-A2.3)

3. Distal zone(32-A3.3)

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J Orthop Trauma• Volume 21, Number 10 Supplement, November/December 2007Femur

Femur, diaphyseal, wedge spiral (32-B1)1. Subtrochanteric zone(32-B1.1)

2. Middle zone(32-B1.2)B1

Femur, diaphyseal, wedge, bending (32-B2)1. Subtrochanteric zone(32-B2.1)2. Middle zone(32-B2.2)

B2

Femur, diaphyseal, wedge fragmented (32-B3)1. Subtrochanteric zone(32-B3.1)2. Middle zone(32-B3.2)

B3

© 2007 Lippincott Williams & Wilkins

3. Distal zone(32-B1.3)

3. Distal zone(32-B2.3)

3. Distal zone(32-B3.3)

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FemurJ Orthop Trauma• Volume 21, Number 10 Supplement, November/December 2007

Femur, diaphyseal, complex spiral (32-C1)(1) pure diaphyseal

(2) proximal diaphysio-metaphyseal(3) distal diaphysio-metaphyseal

1. With 2 intermediate fragments

2. With 3 intermediate fragments(32-C1.1)

(32-C1.2)C1

Femur, diaphyseal, complex segmental (32-C2)1. With 1 intermediate segmental 2. With 1 intermediate segmental andfracture(32-C2.1)additional wedge fragments(32-C2.2)(1) pure diaphyseal(1) pure diaphyseal(2) proximal diaphysio-metaphyseal(2) proximal diaphysio-metaphyseal(3) distal diaphysio-metaphyseal(3) distal diaphysio-metaphyseal(4) oblique lines(4) distal wedge(5) transverse and oblique lines(5) 2 wedges, proximal and distal

C2

Femur, diaphyseal, complex irregular (32-C3)

1. With 2 or 3 intermediate fragments2. With limited shattering (Ͻ5cm)(32-C3.1)(32-C3.2)(1) 2 main intermediate fragments(1) proximal zone(2) 3 main intermediate fragments(2) middle zone

(3) distal zone

C3

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3. With more than 3 intermediate

fragments (32-C1.3)

3. With 2 intermediate segmental

fragments(32-C2.3)(1) pure diaphyseal

(2) proximal diaphysio-metaphyseal(3) distal diaphysio-metaphyseal

3. With extensive shattering (Ն5cm)(32-C3.3)

(1) pure diaphyseal

(2) proximal diaphysio-metaphyseal(3) distal diaphysio-metaphyseal

© 2007 Lippincott Williams & Wilkins

J Orthop Trauma• Volume 21, Number 10 Supplement, November/December 2007

BONE: FEMUR (3)

Location: Distal segment (33)

Femur

Types:

A. Extra-articular (33-A)

B. Partial articular (33-B)C. Complete articular (33-C)

Groups:

Femur, distal, extra-articular (33-A)1. Simple 2. Meta-(33-A1)physeal

wedge (33-A2)

Femur, distal, partial articular (33-B)

2. Medial3. Metaphyseal 1. Lateral 3. Frontalcondyle,complex (33-B3)condyle,

(33-A3)sagittal (33-B1)sagittal

(33-B2)

Femur, distal, complete articular (33-C)1. Articular 3. Multifrag-2. Articularsimple, meta-mentarysimple, meta-physeal simple physeal multi-articular

(33-C1)fracturefragmentary

(33-C3)(33-C2)

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FemurJ Orthop Trauma• Volume 21, Number 10 Supplement, November/December 2007

Subgroups and Qualifications:

Femur, distal, extra-articular simple (33-A1)1. Apophyseal(33-A1.1)2. Metaphyseal oblique or spiral(1) avulsion lateral epicondyle(33-A1.2)(2) avulsion medial epicondyle

A1

Femur, distal, extra-articular, metaphyseal wedge (33-A2)1. Intact wedge(33-A2.1)(1) lateral2. Fragmented lateral(33-A2.2)(2) medial

A2

Femur, distal, extra-articular, metaphyseal complex (33-A3)

1. With an intermediate split segment(33-A3.1)2. Irregular limited to metaphysis(33-A3.2)

A3

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3. Metaphyseal transverse(33-A1.3)

3. Fragmented medial(33-A2.3)

3. Irregular extending to diaphysis

(33-A3.3)

© 2007 Lippincott Williams & Wilkins

J Orthop Trauma• Volume 21, Number 10 Supplement, November/December 2007Femur

Femur, distal, partial articular, lateral condyle, sagittal (33-B1)

1. Simple through the notch(33-B1.1)2. Simple through load bearing sur-face(33-B1.2)

B1

Femur, distal, partial articular, medial condyle, sagittal (33-B2)1. Simple through notch(33-B2.1)2. Simple through load bearing sur-face(33-B2.2)

B2

Femur, distal, partial articular, frontal (33-B3)

1. Anterior and lateral flake fracture

2. Unicondylar posterior (Hoffa)(33-B3.1)

(33-B3.2)(1) lateral(2) medial

B3

© 2007 Lippincott Williams & Wilkins

3. Multifragmentary(33-B1.3)

3. Multifragmentary(33-B2.3)

3. Bicondylar posterior (33-B3.3)

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FemurJ Orthop Trauma• Volume 21, Number 10 Supplement, November/December 2007

Femur, distal, complete articular, articular simple, metaphyseal simple (33-C1)1. T- or Y-shaped with slight displace-2. T- or Y-shaped with marked dis-ment(33-C1.1)placement(33-C1.2)

3. T-shaped epiphyseal(33-C1.3)

C1

Femur, distal, complete articular, articular simple, metaphyseal multifragmentary (33-C2)1. With intact wedge(33-C2.1)2. With fragmented wedge(33-C2.2)3. Complex(33-C2.3)(1) lateral(1) lateral(2) medial(2) medial

C2

Femur, distal, complete articular, articular multifragmentary (33-C3)1. Metaphyseal simple(33-C3.1)2. Metaphyseal multifragmentary

(33-C3.2)

3. Metaphysio-diaphyseal multifrag-mentary (33-C3.3)

C3

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© 2007 Lippincott Williams & Wilkins