Frykman Classification of Colles Fractures

Fractures Extra-articular Intra-articular involving radiocarpal joint Intra-articular involving distal radioulnar joint Intra-articular involving both radiocarpal and distal radioulnar joint

Absent I

Distal Ulnar Fracture Present II

III

IV

VI

VII

VIII

Carpal Instability (Mayo Classification)

Instability (Subluxation) PERILUJNATE Partial or residual CID type Lunatotriquertral dissociation with VISI RADIOCARPAL CIND type VISI DISI Ulnar translation CIC MIDCARPAL CIND type Triquetrohamate (VISI > DISI) Scaphotrapeziotrapezoidal (VISI > DISI) Capitolunate (DISI > VISI) Diffuse laxity (DISI > VISI) Dislocation (Luxation) Fracture-Dislocation

Various stage
Transradiostyloid perilunate

Transosseous Transscaphoid perilunate Scapholunate dissociation with DISI Other combinations Dorsal Bartons Volar Bartons Radial styloid with carpal
translation (ulnar,, dorsal, radial, volar) Lunate fossa with carpal translation

Dorsal Volar Ulnar Various

Potential (but so rare as to be unique)

Malunited Colles fracture

With primary MC instability

With secondary MC instability

CID, Carpal instability dissociative; CIND, carpal instability nondissociative; CIC, carpal instability combined. * Instability, dislocations, and fracture-dislocation combined are the most common wrist destabilization pattern. The most common instability pattern of the group.

Vulnerable Zone of the Carpus

Types of Perilunate Dislocations

Supracondylar fractures

Tip I fara deplasare Tip II cu deplasare laterala dar fara rotatie Tip III cu deplasare laterala si rotatie a condililor humerali Tip IV cu deplasarea condililor humerali si cominutie a suprafetei articulare

Clasificarea fracturilor de humerus

Fracture Location Proximal Middle Distal Direction and Character Transverse Oblique Spiral Segmental Comminuted Associated Soft Tissue Injury Associated Periarticular Injury Associated Nerve Injury Associated Vascular Injury Intrinsic Condition of Bone (normal or pathologic) Fractures of the proximal humerus Nondisplaced Displaced Neer four-part classification AO classification

Modified Classification of Acromioclavicular Joint Injuries ROCKWOOD Type I Sprain of acromioclavicular ligament Acromioclavicular joint intact Coracoclavicular ligaments intact Deltoid and trapezius muscles intact Type II Acromioclavicular joint disrupted Acromioclavicular joint wider: may be slight vertical separation when compared with the normal shoulder Sprain of the coracoclavicular ligaments Corococlavicular interspace might be slightly increased Deltoid and trapezius muscles intact

Type III Acromioclavicular ligaments disrupted Acromioclavicular joint dislocated and the shoulder complex displaced inferiorly Coracoclavicular ligaments disrupted Coracoclavicular interspace 25% to 100% greater than the normal shoulder Deltoid and trapezius muscles usually detached from the distal end of the clavicle Type III Variants "Pseudodislocation" through intact periosteal sleeve Physeal injury Coracoid process fracture Type IV Acromioclavicular ligaments disrupted Acromioclavicular joint dislocated and clavicle anatomically displaced posteriorly into or through the trapezius muscle Coracoclavicular ligaments completely disrupted Coracoclavicular space may be displaced, but may appear same as the normal shoulder Deltoid and trapezius muscles detached from the distal clavicle Type V Acromioclavicular ligaments disrupted Coracoclavicular ligaments disrupted Acromioclavicular joint dislocated and gross disparity between the clavicle and the scapula (ie, 100% to 300% greater than the normal shoulder) Deltoid and trapezius muscles detached from the distal half of the clavicle Type VI Acromioclavicular ligaments disrupted Coracoclavicular ligaments disrupted in subcoracoid type and intact in subacromial type Acromioclavicular joint dislocated and clavicle displaced inferior to the acromion or coracoid process Coracoclavicular interspace reversed in the subcoracoid type (ie, clavicle inferior to the coracoid), or decreased in the subacromial type (ie, clavicle Deltoid and trapezius muscles detached from the distal clavicle

FRACTURILE DE CLAVICULA
Group I middle-third fractures Group II distal-third fractures Type Iminimal displacement (interligamentous) Type IIdisplacement secondary to fracture medial to the coracoclavicular ligaments A. Conoid and trapezoid attached B. Conoid torn, trapezoid attached Type IIIarticular surface fractures Type IVligaments intact to periosteum (children), with displacement of the proximal fragment Type Vcomminuted, with ligaments not attached proximally nor distally, but to an inferior, comminuted fragment Group III proximal-third fractures Type Iminimal displacement Type IIsignificant displacement (ligaments ruptured) Type IIIintra-articular Type IVepiphyseal separation (children and young adults) Type Vcomminuted

Classification of Anterior Glenohumeral Instability

Degree of Stability Dislocation Subluxation Chronology Congenital Acute Chronic Locked (fixed) Recurrent Force Traumatic Atraumatic Patient Contribution Voluntary Involuntary Direction Subcoracoid Subglenoid Intrathoracic

Classification of Sternoclavicular Dislocations

ANATOMIC POSITION Anterior Dislocation Posterior Dislocation (uncommon)

ETIOLOGY Traumatic Sprain or subluxation Acute Dislocation Recurrent Dislocation Unreduced Dislocation Atraumatic Spontaneous Subluxation/Dislocation Congenital/Developmental Arthritis Infection

Andreson and DAlonzo classification of odontoid fracture

Traumatic Spondylolisthesis of the Axis (Effendis classification)

Type I - fractures were isolated, minimally displaced fractures of the ring of the axis, which sometimes could include a portion of the body of C2, and no more than 3 mm of displacement of the fracture in the neural arch Type II - three varieties of the type II fracture, including an extension type, a flexion type, and a listhetic type. These type II fractures all were displaced greater than 3 mm, and the flexion and extension varieties each had significant angulation at the C2C3 disk space. Levine added a type IIA group that he believed represented an injury in which the entire C2C3 disk had been avulsed in flexion, leaving only the anterior longitudinal ligament intact. He chose to list this as a separate injury. Type III - fracture dislocation was rare. He describes the sequence of events as primary anterior dislocation of the C2 facets on the C3 facets with secondary extension fracturing the neural arch. Levine described the type III fracture as primarily flexion-compression type injury.

Dennis three columns theory

A. Coloana anterioara ligamentul longitudinal anterior, portiunea anterioara a corpului

vertebral si inelului fibros

B. Coloana mijlocie ligamnetul longitudinal posterior, portiunea posterioara a corpului

vertebral si inelului fibros

C. Coloana posterioara elementele vertebrale posterioare si elementele ligamentare

posterioare