Neck of femur fracture classification: Difference between revisions

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| style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type I
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type I
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Lateral split [[Bone fracture|fracture]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Supcapital [[Bone fracture|fracture]]
|-
|-
| style="background: #4479BA; color: #FFFFFF; text-align: center;" | Type II
| style="background: #4479BA; color: #FFFFFF; text-align: center;" | Type II
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Lateral Split-depressed [[Bone fracture|fracture]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Transcervical [[Bone fracture|fracture]]
|-
|-
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type III
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type III
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Lateral Pure depression [[Bone fracture|fracture]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Basicervical [[Bone fracture|fracture]]
|-
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type IV
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Medial plateau [[Bone fracture|fracture]]
|-
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type V
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Bicondylar [[Bone fracture|fracture]]
|-
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type VI
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Metaphyseal-diaphyseal [[Dissociation (chemistry)|dissociation]]  
|}
|}


===Garden's Classification===
===Garden's Classification===
* Garden's [[classification]] of neck of femur fracture is most commonly used [[classification]].<ref> Garden RS. Low-angle fixation in fractures of the femoral neck. J Bone Joint Surg Br 1961;43-B:647-63. </ref>
* Garden's [[classification]] of neck of femur fracture is most commonly used [[classification]].<ref>Garden RS. Low-angle fixation in fractures of the femoral neck. J Bone Joint Surg Br 1961;43-B:647-63. </ref>
* It is based on anterioposterior (AP) radiographs and does not consider lateral or sagittal plane alignment.


{| class="wikitable"
{| class="wikitable"
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|-
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| style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type I
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type I
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Coronal split [[fracture]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Incomplete, valgus impacted [[fracture]]
|-
|-
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type II
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type II
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Entire condylar [[Bone fracture|fracture]]  
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Complete, nondisplaced [[Bone fracture|fracture]]  
|-
|-
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type III
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type III
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Rim avulsion [[Bone fracture|fracture]] of lateral plateau
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Complete, partially displaced [[Bone fracture|fracture]]  
|-
|-
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type IV
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type IV
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Rim compression [[Bone fracture|fracture]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Complete, fully displaced [[Bone fracture|fracture]]
|-
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type V
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Four-part [[Bone fracture|fracture]]
|}
|}


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! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Pauwel's Classification
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Pauwel's Classification
|-
|-
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |Zero-column fracture
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type I
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Pure articular depression
| style="background: #F5F5F5; padding: 5px; text-align: center;" |< 30 degree from horizontal
|-
|-
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |1 Column fracture
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type II
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Lateral column [[Bone fracture|fracture]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" |30 to 50 degree from horizontal
|-
|-
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |2 Column fracture
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type III
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Lateral and posterior column [[Bone fracture|fracture]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" |> 50 degree from horizontal
|-
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |3 Column  fracture
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Bicondylar [[Bone fracture|fracture]] dividing into three fragments
|}
|}
===OTA System===
===OTA System===

Revision as of 21:16, 7 February 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rohan A. Bhimani, M.B.B.S., D.N.B., M.Ch.[2]

Overview

There are multiple classifications available for neck of femur fracture. The most common classification systems for neck of femur fracture include Anatomical, Garden's, Pauwel's and AO/OTA classification.

Classification

There are multiple classifications available for neck of femur fracture. The most common classification systems for neck of femur fracture include Anatomical, Garden's, Pauwel's and AO/OTA classification.[1][2]

Anatomical Classification

Anatomical Classification of neck of femur fracture.Source: Case courtesy of Mikael Häggström, using image by Mariana Ruiz Villarreal (LadyofHats [CC0, via Wikimedia Commons]
  • Anatomical classification is the commonly used classification for Neck of femur fracture.[3][4]
Schatzker Classification
Type I Supcapital fracture
Type II Transcervical fracture
Type III Basicervical fracture

Garden's Classification

  • Garden's classification of neck of femur fracture is most commonly used classification.[5]
  • It is based on anterioposterior (AP) radiographs and does not consider lateral or sagittal plane alignment.
Garden's Classification
Type I Incomplete, valgus impacted fracture
Type II Complete, nondisplaced fracture
Type III Complete, partially displaced fracture
Type IV Complete, fully displaced fracture

Pauwel's Classification

  • Pauwel's classified for neck of femur fracture is based on vertical orientation of fracture line.[6]
  • Pauwel's angle is defined as the angle formed between the line of a fracture of the neck of the femur and the horizontal on an anterioposterior radiograph.
  • The greater the angle, the more unstable the fracture and thus worse the prognosis.
Pauwel's Classification
Type I < 30 degree from horizontal
Type II 30 to 50 degree from horizontal
Type III > 50 degree from horizontal

OTA System

OTA System
A Extra-articular fractures
A1 Avulsion
A2 Metaphyseal simple
A3 Metaphyseal multifragmentary
B Partial articular fractures
B1 Pure split
B2 Pure depression
B3 Split depression
C Complete articular fractures
C1 Articular simple + metaphyseal simple
C2 Articular simple, metaphyseal multifragmentary
C3 Articular multifragmentary

References

  1. Rockwood, Charles (2010). Rockwood and Green's fractures in adults. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins. ISBN 9781605476773.
  2. Azar, Frederick (2017). Campbell's operative orthopaedics. Philadelphia, PA: Elsevier. ISBN 9780323374620.
  3. Rockwood, Charles (2010). Rockwood and Green's fractures in adults. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins. ISBN 9781605476773.
  4. Azar, Frederick (2017). Campbell's operative orthopaedics. Philadelphia, PA: Elsevier. ISBN 9780323374620.
  5. Garden RS. Low-angle fixation in fractures of the femoral neck. J Bone Joint Surg Br 1961;43-B:647-63.
  6. Pauwels F. Der Schenkelhalsbruch, ein mechanisches problem. Stuttgart: F. Enke; 1935.
  7. ME Muller, S Nazarian, P Koch. Classification AO des fractures. 1 Les os longs. Springler-Verlag, Berlin, 1987.

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