97042 04 Tibia-Fibula - Orthopaedic Trauma …ota.org/media/23063/97042.6Tibia-2fFibula-S43-S58.pdfTransverse fracture of lateral malle-olus (44-A1.3) Tibia/Fibula. 97042_04_Tibia-Fibula

$Page 1: 97042 04 Tibia-Fibula - Orthopaedic Trauma …ota.org/media/23063/97042.6Tibia-2fFibula-S43-S58.pdfTransverse fracture of lateral malle-olus (44-A1.3) Tibia/Fibula. 97042_04_Tibia-Fibula$
BONE: TIBIA/FIBULA (4) Location: Proximal segment (41)

Types:A. Extra-articular (41-A)

Groups:Tibia/fibula, proximal, extra-articular (41-A)1. Avulsion(41-A1)

2. Metaphy-seal simple(41-A2)

3. Metaphysealmultifragmen-tary (41-A3)

B. Partial articular (41-B) C. Complete articular (41-C)

2. Pure de-pression(41-B2)

2. Articularsimple, meta-physeal multi-fragmentary(41-C2)

Tibia/fibula, proximal, partial articular (41-B)1. Pure split(41-B1)

Tibia/fibula, proximal, complete articular (41-C)1. Articular simple, meta-physeal simple(41-C1)

3. Split de-pression(41-B3)

3. Articularmultifrag-mentary(41-C3)

TIBIA/FIBULA

© 2007 Lippincott Williams & Wilkins S43

S44 © 2007 Lippincott Williams & Wilkins

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


Subgroups and Qualifications:Tibia/fibula, proximal, extra-articular, avulsion (41-A1)1. Of fibular head (41-A1.1) 2. Of tibial tuberosity (41-A1.2) 3. Of cruciate insertion (41-A1.3)

(1) anterior(2) posterior

Tibia/fibula, proximal, extra-articular, simple metaphysis (41-A2)1. Oblique in frontal plane (41-A2.1) 2. Oblique in sagittal plane (41-A2.2) 3. Transverse (41-A2.3)

Tibia/fibula, proximal, extra-articular, multifragmentary metaphysis (41-A3)1. Intact wedge (41-A3.1)(1) lateral(2) medial

2. Fragmented wedge (41-A3.2)(1) lateral(2) medial

3. Complex (41-A3.3)(1) slightly displaced(2) significantly displaced

A1

A2

A3

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


Tibia/fibula, proximal, partial articular, depression (41-B2)1. Lateral total (41-B2.1)(1) 1 piece(2) mosaic-like

2. Lateral limited (41-B2.2)(1) peripheral(2) central(3) anterior(4) posterior

3. Medial (41-B2.3)(1) central(2) anterior(3) posterior(4) total

Tibia/fibula, proximal, partial articular, split (41-B1)1. Of lateral surface (41-B1.1)(1) marginal(2) sagittal(3) frontal anterior(4) frontal posterior

2. Of medial surface (41-B1.2)(1) marginal(2) sagittal(3) frontal anterior(4) frontal posterior

3. Oblique, involving the tibial spinesand 1 of the surfaces (41-B1.3)(1) lateral(2) medial

Tibia/fibula, proximal, partial articular, split depression (41-B3)1. Lateral (41-B3.1)(1) antero-lateral depression(2) postero-lateral depression(3) antero-medial depression(4) postero-medial depression

2. Medial (41-B3.2)(1) antero-lateral depression(2) postero-lateral depression(3) antero-medial depression(4) postero-medial depression

3. Oblique involving the tibial spinesand 1 of the surfaces (41-B3.3)(1) lateral(2) medial

B1

B2

B3


S46 © 2007 Lippincott Williams & WilkinsS46 © 2007 Lippincott Williams & Wilkins

2. Medial (41-C3.2)

Tibia/fibula, proximal, complete articular, articular multifragmentary (41-C3)(1) metaphyseal simple(2) metaphyseal lateral wedge(3) metaphyseal medial wedge(4) metaphyseal complex(5) metaphysio-diaphyseal complex1. Lateral (41-C3.1) 3. Lateral and medial (41-C3.3)

Tibia/fibula, proximal, complete articular, simple articular, simple metaphysis (41-C1)(1) intact anterior tibial tubercle and intercondylar eminence(2) anterior tibial tubercle involved(3) intercondylar eminence involved1. Slight displacement (41-C1.1) 2. 1 condyle displaced (41-C1.2) 3. Both condyles displaced (41-C1.3)

Tibia/fibula, proximal, complete articular, articular simple, metaphysis multifragmentary (41-C2)1. Intact wedge (41-C2.1)(1) lateral(2) medial

2. Fragmented wedge (41-C2.2)(1) lateral(2) medial

3. Complex (41-C2.3)

C1

C2

C3



BONE: TIBIA/FIBULA (4) Location: Diaphyseal segment (42)

Types:A. Simple (42-A) B. Wedge (42-B) C. Complex (42-C)

Groups:Tibia/fibula, diaphyseal, simple (42-A)1. Spiral (42-A1) 2. Oblique

(��30°) (42-A2)3. Transverse(��30°)(42-A3)

Tibia/fibula, diaphyseal, wedge (42-B)1. Spiral wedge(42-B1)

2. Bendingwedge (42-B2)

3. Frag-mentedwedge (42-B3)

Tibia/fibula, diaphyseal, complex (42-C)1. Spiral(42-C1)

2. Segmented(42-C2)

3. Irregular(42-C3)



Subgroups and Qualifications:Tibia/fibula, diaphyseal, simple, spiral (42-A1)(1) proximal zone(2) middle zone(3) distal zone1. Fibula intact (42-A1.1) 2. Fibula fracture at different level

(42-A1.2)3. Fibula fracture at same level(42-A1.3)

Tibia/fibula, diaphyseal, simple, oblique (�30°) (42-A2)(1) proximal zone(2) middle zone(3) distal zone1. Fibula intact (42-A2.1) 2. Fibula fracture at different level


Tibia/fibula, diaphyseal, simple, transverse (<30°) (42-A3)(1) proximal zone(2) middle zone(3) distal zone1. Fibula intact (42-A3.1) 2. Fibula fracture at different level


A1

A2

A3



Tibia/fibula, diaphyseal, wedge, spiral (42-B1)(1) proximal zone(2) middle zone(3) distal zone1. Fibula intact (42-B1.1) 2. Fibula fracture at different level

(42-B1.2)3. Fibula fracture at same level(42-B1.3)

2. Fibula fracture at different level(42-B2.2)

3. Fibula fracture at same level(42-B2.3)

Tibia/fibula, diaphyseal, wedge, bending (42-B2)(1) proximal zone(2) middle zone(3) distal zone1. Fibula intact (42-B2.1)

Tibia/fibula, diaphyseal, wedge fragmented (42-B3)(1) proximal zone(2) middle zone(3) distal zone1. Fibula intact (42-B3.1) 2. Fibula fracture at different level

(42-B3.2)3. Fibula fracture at same level(42-B3.3)

B1

B2

B3


S50 © 2007 Lippincott Williams & WilkinsS50 © 2007 Lippincott Williams & Wilkins

Tibia/fibula, diaphyseal, complex, irregular (42-C3)1. With 2 or 3 intermediate fragments(42-C3.1)(1) 2 intermediate fragments(2) 3 intermediate fragments

2. Limited shattering (��4cm)(42-C3.2)

3. Extensive shattering (��4cm)(42-C3.3)(1) pure diaphyseal(2) proximal diaphysio-metaphyseal(3) distal diaphysio-metaphyseal

Tibia/fibula, diaphyseal, complex, spiral (42-C1)(1) pure diaphyseal(2) proximal diaphysio-metaphysis(3) distal diaphysio-metaphysis1. With 2 intermediate fragments(42-C1.1)

2. With 3 intermediate fragments(42-C1.2)

3. With more than 3 intermediatefragments (42-C1.3)

Tibia/fibula, diaphyseal, complex segmental (42-C2)1. With an intermediate segmental fragment (42-C2.1)(1) pure diaphyseal(2) proximal diaphysio-metaphyseal(3) distal diaphysio-metaphyseal(4) oblique lines(5) transverse and oblique lines

2. With an intermediate segmentaland additional wedge fragment(s)(42-C2.2)(1) pure diaphyseal(2) proximal diaphysio-metaphyseal(3) distal diaphysio-metaphyseal(4) distal wedge(5) 3 wedges, proximal and distal

3. With 2 intermediate segmentalfragments (42-C2.3)(1) pure diaphyseal(2) proximal diaphysio-metaphyseal(3) distal diaphysio-metaphyseal

C1

C2

C3



BONE: TIBIA/FIBULA (4) Location: Distal segment (43)

Types:A. Extra-articular (43-A) B. Partial articular (43-B) C. Complete articular (43-C)

2. Metaphy-seal wedge(43-A2)

3. Metaphy-seal complex(43-A3)

Groups:Tibia/fibula, distal, extra-articular (43-A)1. Metaphyseal simple (43-A1)

Tibia/fibula, distal, partial articular (43-B)1. Pure split(43-B1)

2. Split de-pression(43-B2)

3. Multifragmen-tary depression(43-B3)

Tibia/fibula, distal, complete articular (43-C)1. Articular simple, meta-physis simple(43-C1)

2. Articularsimple, meta-physis multi-fragmentary(43-C2)

3. Articularmultifragmen-tary (43-C3)



Subgroups and Qualifications:Tibia/fibula, distal, extra-articular, simple (43-A1)(1) fibula intact(2) simple fracture of fibula(3) multifragmentary fracture of fibula(4) bifocal fracture of fibula1. Spiral (43-A1.1) 2. Oblique (43-A1.2) 3. Transverse (43-A1.3)

Tibia/fibula, distal, extra-articular, wedge (43-A2)(1) fibula intact(2) simple fracture of fibula(3) multifragmentary fracture of fibula(4) bifocal fracture of fibula1. Posterolateral impaction (43-A2.1) 2. Anteromedial wedge (43-A2.2) 3. Extending into diaphysis (43-A2.3)

Tibia/fibula, distal, extra-articular, complex (43-A3)(1) fibula intact(2) simple fracture of fibula(3) multifragmentary fracture of fibula(4) bifocal fracture of fibula1. With 3 intermediate fragments(43-A3.1)

2. More than 3 intermediate frag-ments (43-A3.2)

3. Extending into diaphysis (43-A3.3)

A1

A2

A3



Tibia/fibula, distal, partial articular, pure split (43-B1)(1) fibula intact(2) simple fracture of fibula(3) multifragmentary fracture of fibula(4) bifocal fracture of fibula1. Frontal (43-B1.1)(5) anterior(6) posterior (Volkmann)

2. Sagittal (43-B1.2)(5) lateral(6) medial (medial malleolus)

3. Metaphyseal multifragmentary(43-B1.3)

Tibia/fibula, distal, partial articular, split depression (43-B2)(1) fibula intact(2) simple fracture of fibula(3) multifragmentary fracture of fibula(4) bifocal fracture of fibula1. Frontal (43-B2.1)(5) anterior(6) posterior

2. Sagittal (43-B2.2)(5) lateral(6) medial

3. Of the central fragment (43-B2.3)

Tibia/fibula, distal, partial articular, depression (43-B3)(1) fibula intact(2) simple fracture of fibula(3) multifragmentary fracture of fibula(4) bifocal fracture of fibula1. Frontal (43-B3.1)(5) anterior(6) posterior

2. Sagittal (43-B3.2)(5) lateral(6) medial

3. Metaphyseal, multifragmentary(43-B3.3)

B1

B2

B3



Tibia/fibula, distal, complete articular, articular multifragmentary (43-C3)(1) fibula intact(2) simple fracture of fibula(3) multifragmentary fracture of fibula(4) bifocal fracture of fibula1. Epiphyseal (43-C3.1) 2. Epiphysio-metaphyseal (43-C3.2) 3. Epiphysio-metaphysio-diaphyseal

(43-C3.3)

Tibia/fibula, distal, complete articular, articular simple, metaphyseal simple (43-C1)(1) fibula intact(2) simple fracture of fibula(3) multifragmentary fracture of fibula(4) bifocal fracture of fibula1. Without impaction (43-C1.1)(5) frontal plane(6) sagittal plane

2. With epiphyseal depression(43-C1.2)

3. Extending into diaphysis (43-C1.3)

Tibia/fibula, distal, complete articular, articular simple, multifragmentary metaphysis (43-C2)(1) fibula intact(2) simple fracture of fibula(3) multifragmentary fracture of fibula(4) bifocal fracture of fibula1. With asymmetric impaction(43-C2.1)(5) frontal plane split(6) sagittal plane split

2. Without asymmetric impaction(43-C2.2)

3. Extending into diaphysis (43-C2.3)

C1

C2

C3



BONE: TIBIA/FIBULA (4) Location: Malleolar segment (44)

Types:A. Infrasyndesmotic lesion (44-A)

Groups:Tibia/fibula, malleolar, infrasyndesmotic lesions (44-A)1. Isolated(44-A1)

2. With me-dial malleolarfracture(44-A2)

3. With postero-medialfracture(44-A3)

B. Transsyndesmotic fibula fracture (44-B) C. Suprasyndesmotic lesion (44-C)

2. With me-dial lesion(44-B2)

2. Multifrag-mentary frac-ture of fibulardiaphysis(44-C2)

Tibia/fibula, malleolar, transsyndesmotic fibula frac-ture (44-B)1. Isolated(44-B1)

Tibia/fibula, malleolar, suprasyndesmotic (44-C)

1. Simple dia-physeal fibular fracture (44-C1)

3. With me-dial lesionandVolkmann(fracture ofthe postero-lateral rim)(44-B3)

3. Proximalfibula (44-C3)



Subgroups and Qualifications:Tibia/fibula, malleolar, infrasyndesmotic, isolated (44-A1)1. Rupture of lateral collateral ligament (44-A1.1)

2. Avulsion of tip of lateral malleolus(44-A1.2)

3. Transverse fracture of lateral malle-olus (44-A1.3)

Tibia/fibula, malleolar, infrasyndesmotic lesion with medial malleolar fracture (44-A2)(1) transverse(2) oblique(3) vertical1. Rupture of lateral collateral ligament (44-A2.1)



Tibia/fibula, malleolar, infrasyndesmotic lesion with postero-medial fracture (44-A3)1. Rupture of lateral collateral ligament (44-A3.1)



A1

A2

A3



Tibia/fibula, malleolar, transsyndesmotic, isolated (44-B1)1. Simple (44-B1.1) 2. Simple with rupture of anterior

syndesmosis (44-B1.2)(1) in substance(2) Chaput (anterior tibia)(3) Lefort (anterior fibula)

3. Multifragmentary (44-B1.3)

Tibia/fibula, malleolar, transsyndesmotic fracture with medial lesion (44-B2)1. Simple, rupture of medial collateral and anterior syndesmosis (44-B2.1)(1) in substance(2) Chaput(3) Lefort

2. Simple with fracture of medialmalleolus and rupture of anterior syn-desmosis (44-B2.2)(1) in substance(2) Chaput(3) Lefort

3. Multifragmentary (44-B2.3)(1) rupture of medial collateral ligament(2) fracture of medial malleolus

Tibia/fibula, malleolar, transsyndesmotic with medial lesion and a Volkmann (fracture of posterolateral rim) (44-B3)(1) extra-articular avulsion(2) peripheral articular fragment(3) significant articular fracture1. Fibula simple with medial collateral ligament rupture (44-B3.1)

2. Simple fibula fracture with fractureof medial malleolus (44-B3.2)

3. Multifragmentary with fracture ofmedial malleolus (44-B3.3)

B1

B2

B3



Tibia/fibula, malleolar, suprasyndesmotic, proximal fibular lesion (44-C3)(1) fracture through neck(2) fracture through head(3) proximal tibiofibular dislocation(4) rupture of medial collateral ligament(5) fracture of medial malleolus(6) articular fragment1. Without shortening, without Volkmann (44-C3.1)

2. With shortening, withoutVolkmann (44-C3.2)

3. Medial lesion and a Volkmann(44-C3.3)

Tibia/fibula, malleolar, suprasyndesmotic, multifragmentary fibular diaphyseal fracture (44-C2)1. With rupture of medial collateral ligament (44-C2.1)

2. With fracture of medial malleolus(44-C2.2)

3. With fracture of medial malleolusand a Volkmann (Dupuytren)(44-C2.3)(1) extra-articular avulsion(2) peripheral articular fragment(3) significant articular fragment

Tibia/fibula, malleolar, susprasyndesmotic, simple diaphyseal fracture of fibula (44-C1)1. Rupture of medial collateral ligament (44-C1.1)

2. With fracture of medial malleolus(44-C1.2)

3. With fracture of medial malleolusand a Volkmann (Dupuytren)(44-C1.3)(1) extra-articular avulsion(2) peripheral articular fragment(3) significant articular fragment

C1

C2

C3

Documents

97042 04 Tibia-Fibula - Orthopaedic Trauma …ota.org/media/23063/97042.6Tibia-2fFibula-S43-S58.pdfTransverse fracture of lateral malle-olus (44-A1.3) Tibia/Fibula. 97042_04_Tibia-Fibula