Orthopedic Navigator: An Orthopedic Guide for Postgraduates Jacob Ipe, Febin Ahamed PI, Jacob Eapen
INDEX
A
Acetabular depth 124
Acetabular index 124
Acetabular version 125
Acetabulum fracture 18
Achterman and Kalamchi classification 89
Acromioclavicular joint 115
injuries 3
Adult respiratory distress syndrome 110
Aitken's classification 84
Allen classification 15
Allman classification 1
Alpha and beta angles 65
Anal atresia 81
Anatomical axis 127
Anderson and d'Alonzo classification 47
Anderson and Montesano classification 45
Ankle 132
fractures 30
Ankylosing spondylitis 106
Anomalies, congenital 78
AO classification 29
Apert syndrome 82
Aplasia, partial 83
Arc
first 14
greater 13
lesser 13
second 14
third 14
Arnold and Hilgartner classification, modified 104
Arthritis 107
Arthroscopic classification 54
Arthroscopic staging 51
Atlantoaxial rotatory subluxation and dislocation 47
Atlanto-occipital dislocation 46
Atlas fracture 46
Avascular necrosis 65
B
Bado classification 9
Bateman classification 54
Baumann's angle 117
Baumgartner index 111
Beighton criteria 110
Bending injury 11
Berndt and Harty classification 70
Best motor response 93
Best verbal response 94
Bimastoid line 139
Bipartite patella 69
Blackburne-Peel index 131
Blauth classification 82
Blount's disease 84
Blumensaat's line 129
Bohler's angle 133
Bone
destruction, pattern of 101
forearm fracture, both 42
Boyd and Griffin classification 23
Boyd and Knight classification 34
Boyd classification 85
Brachial plexus injury 53
Brain injury 94
Breathing, increased 110
Burst fracture 47
C
Calcaneus fracture 35
Calcific tendinitis 51
Cam impingement 67
Campanacci classification 100
Cardiac defects 81
Carrying angle 118
Caton-Deschamps index 130
Catterall classification 59
Cavendish classification 78
Center-edge angle 125
Central stenosis 73
Cervical spine 136139
Chamberlain line 138
Charcot's arthropathy 71
Checketts-Otterburn grading 99
Cheng's clinical group 79
Choi's classification 99
Chondromalacia patella 68
Chopart fracture 36
Cierny-Mader classification 96
Clavicle fracture 1
Cobb angle, indirect 141
Cobb method 140, 141
Cofield classification 54
Condyle humerus physeal fractures, lateral 41
Contralateral hip 125
Coronoid fracture 7
Crawford classification 86
C-reactive protein 106
Crowe classification 63
Crude memorization technique 32
Cuff tears, complete 54
Cuff, width of 113
D
Dameron-Lawrence-Bofte classification 37
Danis-Weber classification 32
de Carvalho index 131
de Lee classification 37
Degenerative spondylolisthesis 75
Degenerative triangular fibrocartilage complex tears, classification of 15
Delbet classification 43
Denis classification 50
Diabetic foot 71
Diffuse idiopathic skeletal hyperostosis 108
Diffuse osteomyelitis 97
Digastric line 140
Dimeglio scoring 87
Disk
degeneration 76
extrusion 75, 76
prolapse 75, 76
protrusion 75, 76
sequestration 75, 76
Displacement, direction of 55
Distal femur fracture 25
Distal radioulnar joint 15
Distal radius fracture 11
Doyle classification 15
Dupuytren's contracture 53
Dysplastic spondylolisthesis 75
E
Eastwood classification 53
Eichenholtz classification 71
Elbow 116
dislocation 7
heterotopic ossification of 103
instability 55
shaft condylar angle 118
Elementary fracture 18
Elephant foot 94
Elizabethtown classification 62
Ellis classification, modified 29
End-organ damage 109
Enneking classification 99
Enthesitis-related arthritis 107
Epstein classification 21
Erythrocyte sedimentation rate 106
Essex-Lopresti classification 35
Evans classification 23
Extraforaminal stenosis 73
Eye opening 94
Eyre-Brook classification 97
F
Fat embolism 109
Fat pad sign 116
Felix classification 102
Femoral shaft fractures 25
Femoroacetabular impingement 67
Femur 102
fracture
head of 21
neck of 22
neglected neck of 22
ipsilateral fractures of 28
neck nonunion 96
Fernandez classification 11
Fibula, hypoplasia of 89
Fibular hemimelia 89
Ficat and Arlet classification 65
Fielding and Hawkins classification 47
Fielding classification 24
Final deformity, calculation of 114
Fingertip injuries 15
Flexibility index 114
Flexor tenosynovitis, criteria for 105
Floating knee 28
Foot 135
and ankle fractures 30
intermetatarsal angle of 135
kite's angle, of 136
Foraminal stenosis 73
Fracture
burst 47
description 101
dislocations 13
elementary 18
lateral mass 47
navicular 36
of distal segment 1
of middle third 1
of proximal third 2
open 90
posterior arch 46
radius 12
sacral 50
simple 18
types of 46
Frankel classification, modified 45
Fraser classification 28
Frykman classification 12
G
Gait 91
Galeazzi fracture 11
Ganga diabetic foot classification 71
Ganga Hospital Scoring System 92
Ganz subtypes 67
Garden classification 22
Gartland classification 40
Giant cell tumor 100
Gibbus deformity 75
Gilula's arc 120
Gilula's lines 14
Gissane's angle 134
Glasgow Coma Scale 93
Glenohumeral dislocation 5
Gothic arch 115
Graham's criteria 123
Griffith Seddon classification 77
Gunshot wound 91
Gurd and Wilson's criteria 109
Gustilo-Anderson classification 90
H
Hallux interphalangeal angle 135
Hallux valgus 70
angle 135
Hamanishi classification 88
Hand anomalies, congenital 80
Hangman's fracture 48
Hasting and Grahams classification 103
Hawkins classification 34
Head sphericity 125
Heikel classification 81
Hemitransverse
anterior 20
posterior 20
Hemophilia 104
Herbert classification 12
Hereditary multiple exostoses 100
Herring lateral pillar classification 60
Hilgenreiner epiphyseal angle 126
Hilgenreiner line 126
Hindfoot contracture score 87
Hip 123
biomechanics of 111
developmental dysplasia of 63
dislocation 20
periprosthetic fracture of 101
ultrasound of affected 65
Hohl-Moore classification 28
Horse hoof 94
Humeral and radiocapitellar lines, X-ray anterior 117
Humeral line, anterior 116
Hunka classification 97
Hyperlaxity 110
Hypoplasia 83
Hypoplastic radius 81
I
Ideberg classification 2
Ilioischial line 123
Iliopectineal line 123
Iliopubic line 123
Ilium 123
Ilizarov lengthening 112
Impaction injury 11
Impingement syndrome 51
Infraclavicular lesion 54
Injury severity score 92
Insall-Salvati index 113, 129
Insertional tendinitis 72
Intercondylar humerus fracture 6
Intermetatarsal angle, first-second 135
Intertrochanteric fractures 23
Intervertebral disk prolapse 75
Intra-articular fractures 16
glenoid 2
Isthmic spondylolisthesis 75
J
Jakob classification 41
Jefferson's fracture 46, 47
Jersey finger 16
Johnson and Strom classification 72
Jones, Barnes, Lloyd-Roberts classification 88
Juvenile rheumatoid arthritis 107
K
Kalamchi classification 84
Kanavel's sign 105
Kellgren and Lawrence classification 67
Kidner classification 69
Kienbock's disease 57
Kite's angle 136
Klein's line 126
Knee 128
dislocation 28
Kocher criteria 105
Kumar's clinicoradiological classification 77
Kuwada algorithm 72
Kyphosis 75
congenital 75
mild 77
moderate 77
severe 77
L
Langenskiold classification 84
Lauge-Hansen classification 30
Leddy classification 16
Leighton classification 96
Letournel and Judet classification 18
Letts’ classification 11
Levine and Edwards classification 46, 48
Lewis and Rorabeck classification 102
Lichtman classification 57
Limb
abnormalities 81
ischemia 91
length discrepancy 103, 112
Lindeque criteria 109
Lisch nodules 108
Lisfranc fracture 35
Looser classification 104
Lower limb 113
regional conditions 59
scanogram of bilateral 128
trauma 17
Lumbar canal stenosis 73
anatomic classification 73
M
Maculé-Beneyto classification 11
Madelung deformity 83
Main and Jowett classification 36
Mallet finger 15
Mangled Extremity Severity Score 91
Mann's classification 70
Masada classification 100
Mason classification 9
Mass fracture, lateral 47
Mast and Pappas classification 33
Matsen's classification 5
Mayfield classification 57
Mayo classification 8
McAfee classification 49
McGregor line 138
McRae line 139
Meary's angle
anteroposterior 135
lateral 135
Mechanical axis 127
Medial condyle humerus physeal fractures 41
Medullary osteomyelitis 97
Mehne and Matta classification 6
Menelaus method 112
Metaphyseal blanch sign 127
Metaphyseal-diaphyseal angle 118
Metatarsal fracture 37
Meyerding's classification 73
Midfoot contracture score 87
Milch classification 41
Mirels’ criteria 107
Monteggia equivalents 10
Monteggia fracture 9
pediatric 11
Morrey and Peterson's criteria 105
Motor vehicle accident 91
Muller AO classification 25
Multiple myeloma 109
Musculotendinous and nerve units 93
Myerson algorithm 72
Myerson classification 36
N
Nail size, calculation of 112
Neck of femur, fractures of 43
Neck shaft angle 125
Neer classification 3
Neer-Horowitz classification 39
Nervous system tumors 79
Neurofibromatosis 108
Neurogenic origin 78
Noninsertional tendinitis 72
Nonosseous 79
Nonunion 94
Nutritional kyphosis 75
O
O'brien classification 42
O'driscoll classification 55
Occipital condyle fracture 45
Odontoid process, fractures of 47
Ogden modification 39
Olecranon fracture 8
Oligoarthritis 107
Orthopedics, formulas in 111
Osseous 79
classification 67
origin 78
Osteoarthritis 67
Osteochondritis dissecans 70
Osteogenesis imperfecta 104
Osteomyelitis 96
diagnosing 105
localized 97
superficial 97
Osteotomy
change in length after 112
wedge 111
Outerbridge classification 68
P
Paley classification 95
Paraplegia
early-onset 77
late-onset 77
Patella
alta 129
baja 129
fracture classification 26
Pathologic spondylolisthesis 75
Pauwel's classification 22
Pediatric trauma 38
Peltola and Vahvanen's criteria 105
Pelvic
fracture 17
pediatric 43
incidence 146
slope angle 145
tilt 145
angle 146
Pelvis
false 123
ilioischial line 124
iliopectineal line 124
iliopubic line 124
true 123
Percentage slip calculation 143
Perilunate dislocation 13, 57
Perilunate instability 120
Periprosthetic fracture around knee 102
Periprosthetic infection 103
Perkin's line 125
Perthes disease 59
Peterson type fracture 38
Physiologic host 96
Piece-of-pie sign 120
Pin tract site infection 99
Pincer impingement 67
Pipkin classification 21
Pirani scoring 87
Plexiform neurofibroma 108
Plumb line 140, 144
Polyarthritis 107
Post-traumatic kyphosis 75
Postural kyphosis 75
Powers ratio 137
Pronation external rotation 31
Proximal and distal rows 120
Proximal femoral focal deficiency 84
Proximal humerus fracture 3, 39
Proximal tibial fractures 27
Psoriatic arthritis 107
Pubis 123
Q
Quadriceps angle 128
Quenu and Kuss classification 35
R
Radial bow calculation 113
Radial club hand 81
Radial head
and neck fractures 42
classification 9
Radial height 121
and ulnar variance 122
Radial inclination 121
Radiocapitellar line 117
Radiological lines 115
Radioulnar synostosis, congenital 79
Radius, partial absence of 81
Recess stenosis, lateral 73
Recurrent shoulder dislocation 5
Reflex sympathetic dystrophy 58
Regan and Morrey classification 7
Renal abnormalities 81
Resnick and Niwayama criteria 108
Respiratory failure 110
Respiratory symptoms 110
Retropharyngeal space 137
Rheumatism classification 106
Rheumatoid arthritis 106
functional classification of 103
Rheumatoid factor 106
Rib vertebral angle difference 142
Ring constriction syndrome 83
Riseborough and Radin classification 6
Risser sign 126
Rockwood classification 3
Rolando and Bennett fracture 16
Rome's criteria 106
Rotator cuff tears 54
partial thickness 54
Ruedi and Allgower classification 33
Russell-Taylor classification 24
S
Sacral slope 145
Sagittal balance 144
Salter-Harris
classification 39
fracture 41
physeal injury 38
Salter-Thompson classification 59
Sanders classification 35
Sandhu's classification 22
Sangeorzan's classification 36
Saupe classification 69
Scaphoid fracture 12
Scaphoid lunate advanced collapse 56
Scapholunate dissociation 120
Scapula
fractures 2
winging of 78
Schams sign 126
Schatzker classification 27
Schenck classification 28
Scheuermann's kyphosis 75
Schöttle's point 129
Scoliosis 114
and plumb line 141
positive 141
Scottish terrier sign 143
Seinsheimer classification 25
Septic arthritis
acute 105
sequelae 97
Serology 106
Shaft condylar angle 118
Shapiro classification 103, 104
Shear injury 11
Shenton's angle 124
Shenton's line 123
Shock 91
Short distal radius 81
Shoulder 115
Sillence classification 104
Singh index 127
Skeletal structures 93
bone and joints 93
Skeletal tissue injury 91
Slip angle 144
calculation 144
Slip, percentage of 143
Slipped capital femoral epiphysis 63
Snyder classification 52
Soft-tissue
injury 91
origin 78
Spilled teacup sign 121
Spinal cord injury 45
Spinal disorders 73
Spinal tuberculosis 76
anatomical involvement 76
Spine 136
at risk 107
instability 108
trauma 45
Spondylolisthesis 73
Spondyloptosis 73
Spoon hand 83
Sprengel's shoulder 78
Steinberg classification 66
Stulberg classification 61
Subtrochanteric femur fractures 24
Sulcus angle 131
Superior labrum
anterior tear 52
posterior tear 52
Supination external rotation 30
Supination-adduction 30
Supracondylar elbow fracture 40
Swanson classification 80, 83
Syndactyly 82
Systemic arthritis 107
T
Talar body fracture 34
Talar neck fractures 34
Talar shift 133
Talar tilt 132
Talipes equinovarus, congenital 87
Talocalcaneal angle 136
Talocrural angle 132
Talus 70
Tear drop 119, 123, 124
Tendo Achilles
chronic injury classification 72
disorders 72
Terry Thomas sign 120
Thompson and Epstein classification 20
Thoracolumbar fractures 49
Thoracolumbar injury classification 49
Thoracolumbar scoliosis 141
Thumb
anomaly types 81
fractures of base of 16
hypoplasia of 82
Tibia 102
congenital pseudarthrosis of 85
hemimelia 88
ipsilateral fractures of 28
vara, congenital 84
Tibial fractures 29
Tibial pilon fracture 33
Tibial tubercle fractures 44
Tibial tuberosity 132
index 113
Tibialis posterior insufficiency 72
Tibiocalcaneal angle 133
Tibiofemoral alignment 129
Tibiofibular clear space 132
Tibiofibular overlap 132
Tibiofibular shaft fractures 29
Tibiotalar angle 134
Tile classification 17
Tip-apex distance 111
Tissues, functional 93
Tönnis angle 124
Torg ratio 137
Torode and Zieg classification 43
Torsion wedge 95
Torticollis 79
Tourniquet pressure 113
Trabecular alignment, displacement of 22
Tracheal-esophageal abnormalities 81
Traumatic spondylolisthesis 48, 75
Traumatic triangular fibrocartilage complex injuries, classification of 14
Traynelis classification 46
Trethowan sign 126
Triangular fibrocartilage injuries 14
Trigger finger 53
Triphalangism 80
Trochlear dysplasia 131
Tscherne classification 90
Tsukayama classification 103
TT:TG distance 132
Tuberculosis spine 114
paraplegia 76, 77
Tuli staging of 76
Tumor, malignant 99
U
Ulna, bowed 81
Ulnar club hand 83
Ulnar styloid fracture 12
Ulnar variance 122
Ultrasound classification system, Graf method for 64
Umbilical artery, single 81
Upper limb 113
regional conditions 51
trauma 1
V
Valgus posterolateral rotatory 55
Vancouver classification 101
Vender and Watson classification 83
Vertebral abnormalities 81
Vertical talus, congenital 88
Volar inclination 122
Volar tilt 122
W
Wackenheim line 139
Wagner classification 71
Waldenström sign 125
Watson and Jones classification 44
Watson classification 56
Weber classification 94
White and Panjabi criteria 108
Wilkins classification 42
Wiltse-Newman classification 75
Winquist and Hansen classification 25
Wrist 119
Wynne-Davies criteria 110
Y
Young-Burgess classification 18
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Chapter Notes

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Upper Limb TraumaCHAPTER 1

 
CLAVICLE FRACTURE
 
Allman Classification
  • Group 1: Fracture of the middle third
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  • Group 2: Fracture of distal segment
    • Type 1: Displaced secondary to a fracture medial to the coracoclavicular (CC) ligaments
    • Type 2: Conoid and trapezoid attached to the proximal segment
    • Type 3: Conoid torn and trapezoid attached
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2
  • Group 3: Fracture of proximal third
    • Type 1: Minimal displacement
    • Type 2: Displaced
    • Type 3: Intra-articular
    • Type 4: Epiphyseal separation
    • Type 5: Comminuted
 
SCAPULA FRACTURES
 
Ideberg Classification (Intra-articular Glenoid Fracture)
  • Type 1: Avulsion fracture of the anterior margin
  • Type 2a: Transverse fracture through the glenoid fossa exiting inferiorly
  • Type 2b: Oblique fracture through the glenoid fossa inferiorly
  • Type 3: Oblique fracture through the glenoid fracture through the glenoid exiting superiorly; often associated with an acromioclavicular (AC) joint injury
  • Type 4: Transverse fracture exiting through the medial border of the scapula
  • Type 5: Combination of a type 2 and type 4 pattern
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3
 
Acromioclavicular Joint Injuries
 
Rockwood Classification
  • Type 1: Sprain of the AC ligament
  • Type 2: AC ligament tear and CC ligaments sprained
  • Type 3: AC and CC ligaments torn
  • Type 4: Type 3 with distal clavicle displaced posteriorly into or through the trapezius
  • Type 5: Type 3 with the distal clavicle grossly displaced superiorly
  • Type 6: AC dislocated with the clavicle displaced inferior to the acromion or coracoid
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PROXIMAL HUMERUS FRACTURE
 
Neer Classification
  • Minimally displaced or undisplaced fracture
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4
  • 2-part fracture: It may be greater tuberosity fracture, lesser tuberosity fracture, surgical neck fracture or anatomical neck fracture.
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  • 3-part fracture: Usually the fragments are—greater tuberosity and surgical neck; lesser tuberosity and surgical neck
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  • 4-part fracture: The four parts are greater and lesser tuberosities, shaft and humeral head.
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5
 
GLENOHUMERAL DISLOCATION
 
Anatomical Classification
  • Anterior dislocation
  • Inferior dislocation (Luxatio erecta)
  • Posterior dislocation
  • Superior dislocation
 
Anterior Dislocation
  • Subclavicular
  • Subcoracoid
  • Intrathoracic
 
Posterior Dislocation
  • Subacromial
  • Subglenoid
  • Subspinous
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Recurrent Shoulder Dislocation
 
Matsen's Classification
This classification is for recurrent shoulder dislocation.
  • TUBS: Traumatic unilateral, with a Bankart's lesion, requires surgery
  • AMBRII: Atraumatic, multidirectional and bilateral, responds to rehabilitation occasionally requires an inferior capsular shift and internal closure.6
 
INTERCONDYLAR HUMERUS FRACTURE
 
Riseborough and Radin Classification
  • Type 1: Nondisplaced
  • Type 2: Slight displacement with no rotation between the condylar fragment
  • Type 3: Displacement with rotation
  • Type 4: Severe comminution of the articular surface
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Mehne and Matta Classification
  • High T
  • Low T
  • Y-type
  • H-type
  • Medial
  • Lateral
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7
 
ELBOW DISLOCATION
 
Anatomical Classification
  • Posterior
    • Posterolateral: >90% dislocations
    • Posteromedial
  • Anterior
  • Lateral
  • Medial
  • Divergent (rare)
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CORONOID FRACTURE
 
Regan and Morrey Classification
  • Type I: Avulsion of the tip of the coronoid process8
  • Type II: Involving <50% of the process
  • Type III: Involving >50% of the process, there may be an associated valgus instability, since medial collateral ligament inserts onto the fracture fragment.
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OLECRANON FRACTURE
 
Mayo Classification
  • Types 1A and 1B: Undisplaced (>2 mm) fractures with no comminution (type 1A) or with comminution (type 1B)
  • Type 2A: Stable fracture with 3 mm displacement, no comminution
  • Type 2B: Stable fractures with 3 mm displacement; comminution is present.
  • Type 3: Unstable, displaced fracture–dislocations; no comminution is present.
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9
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RADIAL HEAD CLASSIFICATION
 
Mason Classification
  • Type 1: Nondisplaced fractures
  • Type 2: Marginal fractures with displacement
  • Type 3: Comminuted fractures involving the entire head
  • Type 4: Associated with dislocation of the elbow
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MONTEGGIA FRACTURE
 
Bado Classification
  • Type 1: Anterior dislocation of the radial head with fracture of the ulnar diaphysis at any level with anterior angulation10
  • Type 2: Posterior/posterolateral dislocation of the radial head with fracture of the ulnar diaphysis with posterior angulation
  • Type 3: Lateral/anterolateral dislocation of the radial head with fracture of the ulnar metaphysis
  • Type 4: Anterior dislocation of the radial head with fractures of the both the radius and ulna within proximal third at the same level
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Monteggia Equivalents
  • Type I equivalents:
    • Isolated dislocation of radial head
    • Radial neck fracture (isolated)
    • Radial neck fracture in combination with a fracture of the ulnar diaphysis
    • Radial and ulnar fractures with the radial fracture above the junction of the middle and proximal thirds
    • Fracture of ulnar diaphysis with anterior dislocation of radial head and an olecranon fracture.
    11
  • Type II equivalents: Fractures of the proximal radial epiphysis or radial neck.
  • Type III and Type IV equivalents: Fractures of the distal humerus in association with proximal forearm fractures.
 
Letts’ Classification of Pediatric Monteggia Fractures
  • Type A (Plastic deformation of ulna)
  • Type B (Greenstick fracture of ulna)
  • Type C (Ulna complete fracture) is analogous to Bado type-I
  • Type D is analogous to Bado type-II
  • Type E is analogous to Bado type-III
 
GALEAZZI FRACTURE
 
Maculé–Beneyto Classification
Based on the location of radius fracture from the styloid.
  • Type 1: 60% of the fractures were located within 10 cm from the styloid.
  • Type 2: 30% of the fractures were located 10–15 cm from the styloid.
  • Type 3: 10% of the fractures were >15 cm from the styloid.
 
DISTAL RADIUS FRACTURE
 
Fernandez Classification
  • Type 1 (Bending injury): Colles’ fracture and Smith fracture
  • Type 2 (Shear injury): Volar Barton and Dorsal Barton
  • Type 3 (Impaction injury): Complex articular fractures and radial pilon fracture
  • Type 4 (Avulsion): Radiocarpal fracture dislocations
  • Type 5 (High velocity): High-velocity injuries
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12
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Frykman Classification
Frykman classification
Radius fracture
Ulnar styloid fracture
Absent
Present
Extra-articular
1a
2a
Intra-articular involving radiocarpal joint
1b
2b
Intra-articular involving distal radioulnar joint (DRUJ)
1c
2c
Intra-articular involving radiocarpal and DRUJ
1d
2d
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SCAPHOID FRACTURE
 
Herbert Classification
  • Type A: Fractures include:
    • A1: Fractures of the tubercle
    • A2: Incomplete fractures through the waist, which are inherently stable 13
  • Type B: Fractures are acute and unstable; they include:
    • B1: Distal oblique fractures
    • B2: Complete fractures through the waist
    • B3: Proximal pole fractures
    • B4: Transscaphoid perilunate fracture—dislocations of the carpus
  • Type C: Delayed unions
  • Type D: Established nonunion
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PERILUNATE DISLOCATIONS AND FRACTURE DISLOCATIONS
  • Greater arc: A greater arc injury passes through the scaphoid, capitate and triquetrum and often results in trans-scaphoid transcapitate perilunate fracture dislocations.
  • Lesser arc: A lesser arc injury follows a curved path through the radial styloid, midcarpal joint and lunotriquetral space and results in perilunate and lunate dislocations.14
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Note: Gilula's lines are three arcs drawn on an AP radiograph of the wrist used to assess the alignment of the carpal bones. There should be no step-off in the contour of the lines when drawn on a normal wrist.
  • First arc running along the proximal convexity of the scaphoid, lunate and triquetrum.
  • Second arc running along the distal concavities of the scaphoid, lunate and triquetrum.
  • Third arc running along the proximal curvatures of the capitate and hamate.
 
TRIANGULAR FIBROCARTILAGE INJURIES
Classification of traumatic triangular fibrocartilage complex (TFCC) injuries
Class
Characteristics
1A
Central perforation or tear
1B
Ulnar avulsion with or without ulnar styloid fracture
1C
Distal avulsion (origins of UL and UT ligaments)
1D
Radial avulsion (involving the dorsal and/or volar radioulnar ligaments)
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15
Classification of degenerative triangular fibrocartilage complex (TFCC) tears
Class
Characteristics
2A
TFCC wear
2B
2A+ Lunate or ulnar chondromalacia
2C
TFCC perforation + lunate and /or ulnar chondromalacia
2D
2C + LT ligament disruption
2E
2D + Ulnocarpal and DRUJ arthritis
(DRUJ: distal radioulnar joint)
 
FINGERTIP INJURIES
 
Allen Classification
  • Type I: Injuries involve only the pulp
  • Type II: Injuries involve the pulp and nail bed
  • Type III: Injuries include partial loss of the distal phalanx
  • Type IV: Injuries are proximal to the lunula
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Mallet Finger
 
Doyle Classification
  • Type 1: It is a tendinous rupture from the distal phalanx.
  • Type 2: It is a tendinous laceration at or proximal to the DIP joint.
  • Type 3: It is a deep abrasion with loss of extensor substance.
  • Type 4: It includes a significant fracture of the distal phalanx.
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16
 
Jersey Finger
 
Leddy Classification
  • Type 1: Tendon retracts into the palm with or without a bony fragment.
  • Type 2 (most common): The tendon retracts to the proximal interphalangeal joint and the long vinculum remains intact. Type 1 and type 2 injuries may have a small bony avulsion.
  • Type 3: Injuries involve a large bony fragment.
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Fractures of Base of Thumb
  • Extra-articular fractures
  • Intra-articular fractures (Rolando and Bennett fracture): Rolando is comminuted intra-articular fracture, whereas, Bennett fracture is simple intra-articular fracture.
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