ao/ota fracture and dislocation classification long-bone ......2u2 2u1 31 32 33 4f1 4f2 41 43 42 4f3...

30°>− 30°<

30°>− 30°<

p

a

p

a

30°>− 30°<

30°>−

30°>−

30°<

30°<

p

a

p

a

p

a

p

a

p

a

a

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a

p

p

a

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11

12

13

2R1

2R2

2R3 2U3

2U2

2U1 31

32

33

4F1

4F2

41

43

42

4F3 44

11A Extraarticular,unifocal,2-part11A1 Tuberosity11A2 Surgicalneck11A3 Vertical

2R1A Extraarticular2R1A1 Avulsionofbicipitaltuberosity2R1A2 Neck,simple2R1A3 Neck,multifragmentary

12A Simple12A1* Spiral12A2* Oblique(≥30°)12A3* Transverse(<30°)

2R2A Simple2R2A1* Spiral2R2A2* Oblique(≥30°)2R2A3* Transverse(<30°)

13A Extraarticular13A1 Avulsion13A2 Simple13A3 Wedgeormultifragmentary

11B Extraarticular,bifocal,3-part

11B1 Surgicalneck

2R1B Partialarticular2R1B1 Simple2R1B3 Fragmentary

12B Wedge12B2* Intactwedge12B3* Fragmentarywedge

2R2B Wedge2R2B2* Intactwedge2R2B3* Fragmentarywedge

13B Partialarticular13B1 Lateralsagittal13B2 Medialsagittal13B3 Frontal/coronalplane

11C Articularor4-part11C1 Anatomicalneck11C3 Anatomicalneckassociatedwith

metaphysealfracture

2R1C Completearticular2R1C1 Simple2R1C3 Multifragmentary

12C Multifragmentary12C2* Intactsegmental12C3* Fragmentarysegmental

2R2C Multifragmentary2R2C2* Intactsegmental2R2C3* Fragmentarysegmental

13C Completearticular13C1 Simplearticular,simplemetaphyseal13C2 Simplearticular,wedgeor

multifragmentarymetaphyseal13C3 Multifragmentaryarticular,wedgeor

multifragmentarymetaphyseal

11A1 12A1 13A111C1 13C111B1 13B111A2 12A2 13A212C2 13C212B2 13B211A3 12A3 13A311C3 12C3 13C312B3 13B3

Forfurtherexplanationaboutthequalifications(*),educationalmaterialsabouttheclassification,andaccesstothecompleteFractureandDislocationClassificationCompendium(MeinbergE,AgelJ,RobertsC,etal.FractureandDislocationClassificationCompendium—2018.J Orthopaed Trauma.2018Jan;32[Suppl1]),pleaseusetheQRcode.

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†Simplifiedversion—formoredetails,pleaseusetheQRcode

Ulna

Femur

Tibia

Fibula

Malleolarsegment

2U1Proximalendsegment

31Proximalendsegment

41Proximalendsegment

4F1Proximalendsegment 4F2Diaphysealsegment 4F3Distalendsegment

42Diaphysealsegment

2U2 Diaphysealsegment

32 Diaphysealsegment

2U3 Distalendsegment

33 Distalendsegment

43 Distalendsegment

2R3 Distalendsegment

2R3A1 2R3C12R3B12R3A2 2R3C22R3B22R3A3 2R3C32R3B3

2R3A Extraarticular2R3A1 Radialstyloidavulsion2R3A2 Simple2R3A3 Wedgeormultifragmentary

2R3B Partialarticular2R3B1 Sagittal2R3B2 Dorsalrim(Barton's)2R3B3 Volarrim(reverseBarton’s,

Goyrand-Smith’sII)

2R3C Completearticular2R3C1 Simplearticularandmetaphyseal2R3C2 Multifragmentarymetaphyseal2R3C3 Multifragmentaryarticular,simple

ormultifragmentarymetaphyseal

2R

Humerus11Proximalendsegment

2R1Proximalendsegment

12 Diaphysealsegment 13 Distalendsegment

2R2C2 2R2C32R2B32R2B2

2R2 Diaphysealsegment

2R1A1 2R2A12R1C12R1B12R1A2 2R2A22R1A3 2R2A32R1B3 2R1C3

Radius

1

2U

3

4

4F

44

2U1A1 2U2A1 2U3A1 2U3B 2U3C2U1B1 2U2B32U1A2 2U2A2 2U3A22U2C22U2B22U1A3 2U2A3 2U3A32U2C32U1B2 2U1C3

2U1A Extraarticular2U1A1 Avulsionoftricepsinsertion2U1A2 Simplemetaphyseal2U1A3 Multifragmentarymetaphyseal

31A Trochantericregion31A1 Simplepertrochanteric31A2 Multifragmentarypertrochanteric,lateral

wallincompetent(≤20.5mm)31A3 Intertrochanteric(reverseobliquity)

41A Extraarticular41A1 Avulsion41A2 Simple41A3 Wedgeormultifragmentary

44A Infrasyndesmoticfibulainjury44A1 Isolatedfibulainjury44A2 Withmedialmalleolarfracture44A3 Withposteromedialfracture

4F2A* Simple4F2B* Wedgeor

multifragmentary

44B Transsyndesmoticfibulafracture44B1 Simplefibulafracture44B2 Withmedialinjury44B3 Withmedialinjuryandfracture

oftheposterolateralrim(Volkmann’sfragment)

4F3A Simple4F3B Wedgeor

multifragmentary

44C Suprasyndesmoticfibulafracture

44C1 Simplediaphysealfibulafracture44C2 Wedgeormultifragmentary

diaphysealfibulafracture44C3 Proximalfibulainjury

2U2A Simple2U2A1* Spiral2U2A2* Oblique(≥30°)2U2A3* Transverse(<30°)

2U3A Extraarticular2U3A1 Styloidprocess2U3A2 Simple2U3A3 Multifragmentary

2U3B Partialarticular 2U3C Completearticular2U2B Wedge2U2B2* Intactwedge2U2B3* Fragmentarywedge

2U2C Multifragmentary2U2C2* Intactsegmental2U2C3* Fragmentarysegmental

31A1

41A1

4F1A

44A1 44B1 44C144A2 44B2 44C2

4F2A 4F3A4F1B 4F2B 4F3B

41C141B141A2 41C241B241A3 41C341B3

31C131B131A2 31C231B231A3 31B3

32A Simplefracture32A1* Spiral32A2* Oblique(≥30°)32A3* Transverse(<30°)

42A Simple42A1* Spiral42A2* Oblique(≥30°)42A3* Transverse(<30°)

33A Extraarticular33A1 Avulsion33A2 Simple33A3 Wedgeormultifragmentary

31B Femoralneck31B1 Subcapital31B2 Transcervical31B3 Basicervical

32B Wedge32B2* Intactwedge32B3* Fragmentarywedge

42B Wedge42B2* Intactwedge42B3* Fragmentarywedge

33B Partialarticular33B1 Lateralcondyle,sagittal33B2 Medialcondyle,sagittal33B3 Frontal/coronal

31C Femoralhead31C1 Split31C2 Depression

32C Multifragmentary32C2* Intactsegmental32C3* Fragmentarysegmental

42C Multifragmentary42C2* Intactsegmental42C3* Fragmentarysegmental

33C Completearticular33C1 Simplearticular,simplemetaphyseal

33C2 Simplearticular,wedgeormultifragmentarymetaphyseal

33C3 Multifragmentaryarticular,simple,wedgeormultifragmentarymetaphyseal

32A1

42A1

33A1 33C133B132A2

42A2

33A232C2

42C2

33C232B2

42B2

33B232A3

42A3

33A332C3

42C3 43A1 43A2 43A3 43B1 43B2 43B3 43C1 43C2 43C3

33C332B3

42B3

33B3

AO/OTAFractureandDislocationClassificationLong-boneFractures

41B Partialarticular41B1 Split41B2 Depression41B3 Splitdepression

41C Completearticular41C1 Simplearticular,simplemetaphyseal41C2 Simplearticular,wedge,or

multifragmentarymetaphyseal41C3 Fragmentaryormultifragmentary

metaphyseal

43A Extraarticular43A1 Simple43A2 Wedge43A3 Multifragmentary

43B Partialarticular43B1 Split43B2 Splitdepression43B3 Depression

43C Completearticular43C1 Simplearticular,simplemetaphyseal43C2 Simplearticular,multifragmentarymetaphyseal43C3 Multifragmentaryarticularandmultifragmentary

metaphyseal

44A3 44B3 44C3

Proximalendsegment

Distalendsegment

Diaphysealsegment

• Pairedlongbonesarecodedseparately.• Endsegmentdeterminationisdonewithboth

bonesasaunit.• Diaphysealfracturescanbefurtherrefined

byaddingthequalificationsa,b,orcforlocation.

aProximal1/3

bMiddle1/3

cDistal1/3

1 Nondisplaced2 Displaced3 Impaction4 Noimpaction5 Dislocation6 Subluxation/ligamentousinstability7 Diaphysealextension8 Articularcartilageinjury9 Poorbonequality10 Replantation11 Amputationassociatedwithafracture12 Associatedwithanonarthroplastyimplant13 Spiraltypefracture14 Bendingtypefracture

Listofuniversalmodifiers†AlphanumericstructureoftheAO/OTAFractureandDislocationClassificationforadults

4F1A* Simple4F1B* Multifragmentary

2U1B Partialarticular2U1B1*Olecranon2U1B2*Coronoid

2U1C Completearticular2U1C3*Olecranonandcoronoid