AO OTA Fracture and Dislocation Classification

Classificationoffracturesoftheendsegmentintothethreefracture
groups
Type
Group
1
A
Extraarticular
AO/OTAFractureand
DislocationClassification
Thisleafletisdesignedtoprovideanintroduction
totheclassificationoflong-bonefractures.
Simple
Wedge
Complex
Split
Depression
Split-depression
Simplearticular,
simple
metaphyseal
Simplearticular,
complex
metaphyseal
Complex
articular,
complex
metaphyseal
B
Partialarticular
C
Articular
Humerus
11 proximal(typesaccordingtotopographyandextentofbonelesion)
11-A1
11-A
11-A1
11-A2
11-A3
11-A2
11-A3
extraarticularunifocalfracture
tuberosity
impactedmetaphyseal
nonimpactedmetaphyseal
11-B1
11-B
11-B1
11-B2
11-B3
11-B2
11-B3
extraarticularbifocalfracture
withmetaphysealimpaction
withoutmetaphysealimpaction
withglenohumeraldislocation
11-C1
11-C
11-C1
11-C2
11-C3
11-C2
11-C3
articularfracture
withslightdisplacement
impactedwithmarkeddisplacement
dislocated
12 diaphyseal
12-A1
12-A
12-A1
12-A2
12-A3
12-A2
12-A3
simplefracture
spiral
oblique(>
_30)
transverse(<30)
12-B1
12-B
12-B1
12-B2
12-B3
12-B2
12-B3
wedgefracture
spiralwedge
bendingwedge
fragmentedwedge
12-C1
12-C
12-C1
12-C2
12-C3
12-C2
12-C3
complexfracture
spiral
segmental
irregular
13 distal
13-A1
13-A
13-A1
13-A2
13-A3
13-A2
extraarticularfracture
apophysealavulsion
metaphysealsimple
metaphysealmultifragmentary
13-A3
13-B1
13-B
13-B1
13-B2
13-B3
13-B2
partialarticularfracture
sagittallateralcondyle
sagittalmedialcondyle
coronal
13-B3
13-C1
13-C
13-C1
13-C2
13-C3
13-C2
13-C3
completearticularfracture
articularsimple,metaphysealsimple
articularsimple,metaphysealmultifragmentary
articularmultifragmentary
Radius/ulna
21 proximal
21-A1
21-A
21-A1
21-A2
21-A3
21-A2
21-A3
ulnafractured,radiusintact
radiusfractured,ulnaintact
bothbones
21-B1
21-B
21-B1
21-B2
21-B3
21-B2
21-B3
articularfracture
onebonearticularfracture,otherextraarticular
21-C1
21-C
21-C1
21-C2
21-C3
21-C2
21-C3
articularfractureofbothbones
simple
oneartic.simple,otherartic.multifragmentary
multifragmentary
22 diaphyseal
22-A1
22-A
22-A1
22-A2
22-A3
22-A2
22-A3
simplefracture
bothbones
22-B1
22-B
22-B1
22-B2
22-B3
22-B2
22-B3
wedgefracture
onebonewedge,othersimpleorwedge
22-C1
22-C2
22-C3
22-C complexfracture
22-C1 ulnacomplex,radiussimple
22-C2 radiuscomplex,ulnasimple
22-C3 bothbonescomplex
23 distal
23-A1
23-A
23-A1
23-A2
23-A3
23-A2
radius,simpleandimpacted
radius,multifragmentary
23-A3
23-B1
23-B
23-B1
23-B2
23-B3
23-B2
partialarticularfractureofradius
sagittal
coronal,dorsalrim
coronal,palmarrim
23-B3
23-C1
23-C
23-C1
23-C2
23-C3
23-C2
23-C3
completearticularfractureofradius
Femur
31 proximal(definedbyalinepassingtransverselythroughthelowerendofthelessertrochanter)
31-A1
31-A
31-A1
31-A2
31-A3
31-A2
31-A3
31-B1
extraarticularfracture,trochantericarea
pertrochantericsimple
pertrochantericmultifragmentary
intertrochanteric
31-B
31-B1
31-B2
31-B3
31-B2
31-B3
extraarticularfracture,neck
subcapital,withslightdisplacement
transcervical
subcapital,displaced,nonimpacted
31-C1
31-C
31-C1
31-C2
31-C3
31-C2
31-C3
articularfracture,head
split(Pipkin)
withdepression
withneckfracture
32 diaphyseal
32-A1
32-A2
32-A3
32-B1
32-B2
32-B3
32-C1
32-C2
32-C3
30
32-A simplefracture
32-A1 spiral
32-A2 oblique(>
_30)
32-A3 transverse(<30)
32-A(13).1=subtrochantericfracture
32-B wedgefracture
32-B1 spiralwedge
32-B2 bendingwedge
32-B3 fragmentedwedge
32-B(13).1=subtrochantericfracture
32-C complexfracture
32-C1 spiral
32-C2 segmental
32-C3 irregular
32-C(13).1=subtrochantericfracture
33 distal
33-A1
33-A
33-A1
33-A2
33-A3
33-A2
33-A3
simple
metaphysealwedgeand/orfragmentedwedge
metaphysealcomplex
33-B1
33-B
33-B1
33-B2
33-B3
33-B2
lateralcondyle,sagittal
medialcondyle,sagittal
coronal
33-B3
33-C1
33-C
33-C1
33-C2
33-C3
33-C2
33-C3
Tibia/fibula
41 proximal
41-A1
41-A
41-A1
41-A2
41-A3
41-A2
41-A3
avulsion
metaphysealsimple
metaphysealmultifragmentary
41-B1
41-B
41-B1
41-B2
41-B3
41-B2
41-B3
puresplit
puredepression
split-depression
41-C1
41-C
41-C1
41-C2
41-C3
41-C2
41-C3
42 diaphyseal
42-A1
42-A
42-A1
42-A2
42-A3
42-A2
42-A3
simplefracture
spiral
oblique(>
_30)
transverse(<30)
42-B1
42-B
42-B1
42-B2
42-B3
42-B2
42-B3
wedgefracture
spiralwedge
bendingwedge
fragmentedwedge
42-C1
42-C
42-C1
42-C2
42-C3
42-C2
42-C3
complexfracture
spiral
segmental
irregular
43 distal
43-A1
43-A
43-A1
43-A2
43-A3
43-A2
simple
wedge
complex
43-A3
43-B1
43-B
43-B1
43-B2
43-B3
43-B2
puresplit
split-depression
multifragmentarydepression
43-B3
43-C1
43-C
43-C1
43-C2
43-C3
43-C2
43-C3
44-A1
infrasyndesmoticlesion
isolated
withfracturedmedialmalleolus
withposteromedialfracture
44-B1
44-B
44-B1
44-B2
44-B3
44-B2
44-B3
transsyndesmoticfibularfracture
isolated
withmediallesion
withmediallesionandVolkmannsfracture
44-C1
44-C
44-C1
44-C2
44-C3
44-A3
44-C2
44-C3
suprasyndesmoticlesion
fibulardiaphysealfracture,simple
fibulardiaphysealfracture,multifragmentary
proximalfibularlesion
Copyright2014byAOFoundation,Switzerland
Checkhazardsandlegalrestrictionsonwww.aofoundation.org/legal
44-A
44-A1
44-A2
44-A3
44-A2
AOE-E1-018.8
44 malleolar
AO/OTAsystemfornumberingtheanatomicallocationofafracture
inthreebonesegments(proximal=1,diaphyseal=2,distal=3)
AlphanumericstructureoftheAO/OTAFractureandDislocation
Classification
91-
Diagnosis=essenceofthefracture
9-C raniomaxillofacialbones
Localization
925152 111-Humerus
1514-
15-C lavicula
14-Scapula
4longbones
Segment
123(4)
3or4
segments
Type
ABC
Group
123
Subgroup
.1.2.3
3types
3groups
3subgroups
125-Spine
13-
Example32-B2
53-
3
femur
212-Radius/
ulna
Bone
1234
Morphology
61-
22 23-
2
diaphyseal
B
wedge
fracture
2
bending
wedge
6-Pelvis/acetabulum
31 62-
32-
11-
21-
31-
41-
12-
22-
32-
42-
13-
23-
33-
43-
7-Hand
3-Femur/patella
33 34 41-
42-
4344-
8-Foot
4-Tibia/fibula
44-
Anatomicallocationofthefracture.Anatomicallocationisdesignatedbytwonumbers:
onefortheboneandoneforitssegment(ulnaandradiusaswellastibiaandfibulaare
regardedasonebone).Themalleolarsegment(44-)isanexception.Theproximaland
distalsegmentsoflongbonesaredefinedbyasquarethesidesofwhichhavethesame
lengthasthewidestpartoftheepiphysis(exceptions31-and44-).
Definitionsoffracturetypesforlong-bonefracturesinadults
Exceptiontothisarefracturesoftheproximalhumerus(11-),proximalfemur(31-),malleoli(44-),subtrochantericfractures(32-)
Segment
Type
A
Extraarticular
Partialarticular
Completearticular
Noinvolvementofdisplacedfracturesthatextend
intothearticularsurface
Partofthearticularcomponentisinvolved,leaving
theotherpartattachedtothemeta-/diaphysis
Simple
Wedge
1Proximal
Articularsurfaceinvolved,metaphysealfracture
completelyseparatesthearticularcomponent
fromthediaphysis
2Diaphyseal
Onefractureline,corticalcontactbetween
fragmentsexceeds90%afterreduction
Threeormorefragments,mainfragmentshave
contactafterreduction
Complex
Threeormorefragments,mainfragmentshave
nocontactafterreduction
3Distal
Extraarticular
Partialarticular
Noinvolvementofdisplacedfracturesthatextend
intothearticularsurface
Partofthearticularcomponentisinvolved,leaving
theotherpartattachedtothemeta-/diaphysis
Completearticular
Articularsurfaceinvolved,metaphysealfracture
completelyseparatesthearticularcomponent
fromthediaphysis
Stepsinidentifyingdiaphysealfractures
Classificationoffracturesofthediaphysisintothethreefracturegroups
Diaphysealfracture
Type
Step
Question
Answer
Whichbone?
Specificbone(X)
Isthefractureattheendorinthe
middlesegmentofthebone?
Middlesegment(X2)
Type:Isthefractureasimpleor
multifragmentaryone(doesithave
>2parts)?
Simple(X2-A)
Istherecontactbetweenboth
fractureendsornot?
Ifthereiscontact,itisawedge
(X2-B)
3a
Group:Isthefracturepattern
causedbyatwisting(spiral)or
bendingforce?
Spiral
Oblique
Transverse
Spiral
Bending
Multifragmentary
Spiral
Segmental
Irregular
A
Simple
Ifitismultifragmentary,goto
step3a
Ifthereisnocontact,itiscomplex
(X2-C)
4
Group
Spiralortwistingforceswillresult
inasimplespiral(X2-A1),aspiral
wedge(X2-B1),oraspiral
fragmentedcomplexfracture
(X2-C1)
B
Wedge
Bendingforcesproducesimple
oblique(X2-A2),simpletransverse
(X2-A3),bendingwedge(X2-B2),
fragmentedwedge(X2-B3),or
complex(X2-C3)fractures
C2fracturesaresegmentalby
definition
C
Complex
Classificationoffracturesoftheendsegmentintothethreefracture
groups
Stepsinidentifyingendsegmentfractures
Endsegmentfracture
Type
Step
Question
Answer
Whichbone?
Specificbone(X)
Isthefractureattheendorinthe
middlesegmentofthebone?
Endsegment
Isthefracturethroughtheproximal
ordistalendsegment?
Proximal(X1)
Type:Doesthefractureenterthe
articularsurface?
Ifitdoesnotenter,itisextraarticular
(XX-A),gotostep6
4a
Group
1
Simple
Wedge
Complex
Split
Depression
Split-depression
Simplearticular,
simple
metaphyseal
Simplearticular,
complex
metaphyseal
Complex
articular,
complex
metaphyseal
A
Extraarticular
Distal(X3)
Ifitenters,itisarticular,goto
step4b
4b
Type:Isitpartialortotalarticular?
Ifpartofthejointisstillattached
tothemeta-/diaphysis,itispartial
articular(XX-B)
B
Partialarticular
Ifitisnotattachedtothediaphysis,
itiscompletearticular(XX-C)
5
Group:Howmanyfracturelines
crossthejointsurface?
Ifthereisoneline,itissimple
Group:Howisthemetaphysis
fractured?
Simple:extraarticular(XX-A1),
orsimplearticular(XX-C1)
Ifthereare>2lines,itis
multifragmentary
Wedge:extraarticular(XX-A2)
Complex:extraarticular(XX-A3),
orsimplearticular(XX-C2),
orcomplexarticular(XX-C3)
C
Articular

AO OTA Fracture and Dislocation Classification

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Classificationoffracturesoftheendsegmentintothethreefracture

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