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

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  • AO/OTA Fracture and Dislocation Classification Long-bone ......2U2 2U1 31 32 33 4F1 4F2 41 43 42 4F3 44 11A Extraarticular, unifocal, 2-part 11A1 Tuberosity 11A2 Surgical neck 11A3
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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 p a p p a p a 11 12 13 2R1 2R2 2R3 2U3 2U2 2U1 31 32 33 4F1 4F2 41 43 42 4F3 44 11A Extraarticular, unifocal, 2-part 11A1 Tuberosity 11A2 Surgical neck 11A3 Vertical 2R1A Extraarticular 2R1A1 Avulsion of bicipital tuberosity 2R1A2 Neck, simple 2R1A3 Neck, multifragmentary 12A Simple 12A1* Spiral 12A2* Oblique (≥ 30°) 12A3* Transverse (< 30°) 2R2A Simple 2R2A1* Spiral 2R2A2* Oblique (≥ 30°) 2R2A3* Transverse (< 30°) 13A Extraarticular 13A1 Avulsion 13A2 Simple 13A3 Wedge or multifragmentary 11B Extraarticular, bifocal, 3-part 11B1 Surgical neck 2R1B Partial articular 2R1B1 Simple 2R1B3 Fragmentary 12B Wedge 12B2* Intact wedge 12B3* Fragmentary wedge 2R2B Wedge 2R2B2* Intact wedge 2R2B3* Fragmentary wedge 13B Partial articular 13B1 Lateral sagittal 13B2 Medial sagittal 13B3 Frontal/coronal plane 11C Articular or 4-part 11C1 Anatomical neck 11C3 Anatomical neck associated with metaphyseal fracture 2R1C Complete articular 2R1C1 Simple 2R1C3 Multifragmentary 12C Multifragmentary 12C2* Intact segmental 12C3* Fragmentary segmental 2R2C Multifragmentary 2R2C2* Intact segmental 2R2C3* Fragmentary segmental 13C Complete articular 13C1 Simple articular, simple metaphyseal 13C2 Simple articular, wedge or multifragmentary metaphyseal 13C3 Multifragmentary articular, wedge or multifragmentary metaphyseal 11A1 12A1 13A1 11C1 13C1 11B1 13B1 11A2 12A2 13A2 12C2 13C2 12B2 13B2 11A3 12A3 13A3 11C3 12C3 13C3 12B3 13B3 For further explanation about the qualifications(*), educational materials about the classification, and access to the complete Fracture and Dislocation Classification Compendium (Meinberg E, Agel J, Roberts C, et al. Fracture and Dislocation Classification Compendium—2018. J Orthopaed Trauma . 2018 Jan;32[Suppl 1]), please use the QR code. Copyright © 2018 by AO Foundation, Switzerland Check hazards and legal restrictions on www.aofoundation.org/legal Please contact [email protected] with any questions or poster orders. AOE-E1-016.6 † Simplified version—for more details, please use the QR code Ulna Femur Tibia Fibula Malleolar segment 2U1 Proximal end segment 31 Proximal end segment 41 Proximal end segment 4F1 Proximal end segment 4F2 Diaphyseal segment 4F3 Distal end segment 42 Diaphyseal segment 2U2 Diaphyseal segment 32 Diaphyseal segment 2U3 Distal end segment 33 Distal end segment 43 Distal end segment 2R3 Distal end segment 2R3A1 2R3C1 2R3B1 2R3A2 2R3C2 2R3B2 2R3A3 2R3C3 2R3B3 2R3A Extraarticular 2R3A1 Radial styloid avulsion 2R3A2 Simple 2R3A3 Wedge or multifragmentary 2R3B Partial articular 2R3B1 Sagittal 2R3B2 Dorsal rim (Barton's) 2R3B3 Volar rim (reverse Barton’s, Goyrand-Smith’s II) 2R3C Complete articular 2R3C1 Simple articular and metaphyseal 2R3C2 Multifragmentary metaphyseal 2R3C3 Multifragmentary articular, simple or multifragmentary metaphyseal 2R Humerus 11 Proximal end segment 2R1 Proximal end segment 12 Diaphyseal segment 13 Distal end segment 2R2C2 2R2C3 2R2B3 2R2B2 2R2 Diaphyseal segment 2R1A1 2R2A1 2R1C1 2R1B1 2R1A2 2R2A2 2R1A3 2R2A3 2R1B3 2R1C3 Radius 1 2U 3 4 4F 44 2U1A1 2U2A1 2U3A1 2U3B 2U3C 2U1B1 2U2B3 2U1A2 2U2A2 2U3A2 2U2C2 2U2B2 2U1A3 2U2A3 2U3A3 2U2C3 2U1B2 2U1C3 2U1A Extraarticular 2U1A1 Avulsion of triceps insertion 2U1A2 Simple metaphyseal 2U1A3 Multifragmentary metaphyseal 31A Trochanteric region 31A1 Simple pertrochanteric 31A2 Multifragmentary pertrochanteric, lateral wall incompetent (≤ 20.5 mm) 31A3 Intertrochanteric (reverse obliquity) 41A Extraarticular 41A1 Avulsion 41A2 Simple 41A3 Wedge or multifragmentary 44A Infrasyndesmotic fibula injury 44A1 Isolated fibula injury 44A2 With medial malleolar fracture 44A3 With posteromedial fracture 4F2A* Simple 4F2B* Wedge or multifragmentary 44B Transsyndesmotic fibula fracture 44B1 Simple fibula fracture 44B2 With medial injury 44B3 With medial injury and fracture of the posterolateral rim (Volkmann’s fragment) 4F3A Simple 4F3B Wedge or multifragmentary 44C Suprasyndesmotic fibula fracture 44C1 Simple diaphyseal fibula fracture 44C2 Wedge or multifragmentary diaphyseal fibula fracture 44C3 Proximal fibula injury 2U2A Simple 2U2A1* Spiral 2U2A2* Oblique (≥ 30°) 2U2A3* Transverse (< 30°) 2U3A Extraarticular 2U3A1 Styloid process 2U3A2 Simple 2U3A3 Multifragmentary 2U3B Partial articular 2U3C Complete articular 2U2B Wedge 2U2B2* Intact wedge 2U2B3* Fragmentary wedge 2U2C Multifragmentary 2U2C2* Intact segmental 2U2C3* Fragmentary segmental 31A1 41A1 4F1A 44A1 44B1 44C1 44A2 44B2 44C2 4F2A 4F3A 4F1B 4F2B 4F3B 41C1 41B1 41A2 41C2 41B2 41A3 41C3 41B3 31C1 31B1 31A2 31C2 31B2 31A3 31B3 32A Simple fracture 32A1* Spiral 32A2* Oblique (≥ 30°) 32A3* Transverse (< 30°) 42A Simple 42A1* Spiral 42A2* Oblique (≥ 30°) 42A3* Transverse (< 30°) 33A Extraarticular 33A1 Avulsion 33A2 Simple 33A3 Wedge or multifragmentary 31B Femoral neck 31B1 Subcapital 31B2 Transcervical 31B3 Basicervical 32B Wedge 32B2* Intact wedge 32B3* Fragmentary wedge 42B Wedge 42B2* Intact wedge 42B3* Fragmentary wedge 33B Partial articular 33B1 Lateral condyle, sagittal 33B2 Medial condyle, sagittal 33B3 Frontal/coronal 31C Femoral head 31C1 Split 31C2 Depression 32C Multifragmentary 32C2* Intact segmental 32C3* Fragmentary segmental 42C Multifragmentary 42C2* Intact segmental 42C3* Fragmentary segmental 33C Complete articular 33C1 Simple articular, simple metaphyseal 33C2 Simple articular, wedge or multifragmentary metaphyseal 33C3 Multifragmentary articular, simple, wedge or multifragmentary metaphyseal 32A1 42A1 33A1 33C1 33B1 32A2 42A2 33A2 32C2 42C2 33C2 32B2 42B2 33B2 32A3 42A3 33A3 32C3 42C3 43A1 43A2 43A3 43B1 43B2 43B3 43C1 43C2 43C3 33C3 32B3 42B3 33B3 AO/OTA Fracture and Dislocation Classification Long-bone Fractures 41B Partial articular 41B1 Split 41B2 Depression 41B3 Split depression 41C Complete articular 41C1 Simple articular, simple metaphyseal 41C2 Simple articular, wedge, or multifragmentary metaphyseal 41C3 Fragmentary or multifragmentary metaphyseal 43A Extraarticular 43A1 Simple 43A2 Wedge 43A3 Multifragmentary 43B Partial articular 43B1 Split 43B2 Split depression 43B3 Depression 43C Complete articular 43C1 Simple articular, simple metaphyseal 43C2 Simple articular, multifragmentary metaphyseal 43C3 Multifragmentary articular and multifragmentary metaphyseal 44A3 44B3 44C3 Proximal end segment Distal end segment Diaphyseal segment • Paired long bones are coded separately. • End segment determination is done with both bones as a unit. • Diaphyseal fractures can be further refined by adding the qualifications a, b, or c for location. a Proximal 1/3 b Middle 1/3 c Distal 1/3 1 Nondisplaced 2 Displaced 3 Impaction 4 No impaction 5 Dislocation 6 Subluxation/ligamentous instability 7 Diaphyseal extension 8 Articular cartilage injury 9 Poor bone quality 10 Replantation 11 Amputation associated with a fracture 12 Associated with a nonarthroplasty implant 13 Spiral type fracture 14 Bending type fracture List of universal modifiers † Alphanumeric structure of the AO/OTA Fracture and Dislocation Classification for adults 4F1A* Simple 4F1B* Multifragmentary 2U1B Partial articular 2U1B1* Olecranon 2U1B2* Coronoid 2U1C Complete articular 2U1C3* Olecranon and coronoid

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Page 1: AO/OTA Fracture and Dislocation Classification Long-bone ......2U2 2U1 31 32 33 4F1 4F2 41 43 42 4F3 44 11A Extraarticular, unifocal, 2-part 11A1 Tuberosity 11A2 Surgical neck 11A3

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

p

a

p

p

a

p

a

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.

Copyright©2018byAOFoundation,SwitzerlandCheckhazardsandlegalrestrictionsonwww.aofoundation.org/legal

Pleasecontactinfo@aotrauma.orgwithanyquestionsorposterorders.AOE-E1-016.6

†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

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