Fracture and Dislocation Classification Compendium - 2007

Abstract

The purpose of this new classification compendium is to republish the Orthopaedic Trauma Association's (OTA) classification. The OTA classification was originally published in a compendium of the Journal of Orthopaedic Trauma in 1996. It adopted The Comprehensive Classification of the Long Bones developed by Müller and colleagues and classified the remaining bones. In this compendium, the introductory chapter reviews new scientific information about classifying fractures that has been published in the last 11 years. The classification is presented in a revised format that is easier to follow. The OTA and AO classification will now have a unified alpha-numeric code eliminating the differences that have existed between the 2 codes. The code was significantly revised for the clavicle and scapula, foot and hand, and patella. Dislocations have been expanded on an anatomic basis and for most joints will be coded separately. This publication should stimulate new developments and interest in a unified language to code and classify fractures. Further improvements in classification will result in better patient care and clinical research.

Treatment With the SIGN Nail in Closed Diaphyseal Femur Fractures Results in Acceptable Radiographic Alignment

“…Inclusion criteria included diaphyseal femur fractures (AO/ Orthopaedic Trauma Association [OTA] classification 32) [8] and patients treated with the standard SIGN nail. Exclusion criteria included open fractures and patients who did not have postoperative radiographs or whose radiographs were not adequate for assessment.…”

“…Significant variability existed for image quality owing to quality of the radiographs and/or the uploaded image, which usually was a digital photograph taken of the radiograph. Postoperative radiographs were assessed and the following information analyzed and recorded: adequacy of radiographs (ie, the ability to assess the radiograph and make planned measurements); location of diaphyseal femur fracture (proximal versus middle versus distal third); fracture classification (AO/OTA classification) [8]; degree of comminution (Winquist and Hansen classification) [16]; antegrade versus retrograde nail; and alignment of the femur or fracture in the coronal and sagittal planes. Adequate reduction was defined as angles of 5°or less in the coronal and sagittal planes.…”

“…Fracture locations in the diaphysis were 89% (448/501) middle, 5% (26/501) proximal, and 5% (27/501) distal (Table 1). The fractures were classified according to the AO/ OTA classification [8] and the most common class of fracture 3 of all fractures in the study sample (Table 2).…”

Dynamic Stress Testing Is Unnecessary for Unimalleolar Supination-External Rotation Ankle Fractures with Minimal Fracture Displacement on Lateral Radiographs

“…Ankle fracture classification systems have been developed by Lauge-Hansen (1), Weber (2,3), and the Orthopaedic Trauma Association Committee for Coding and Classification (OTA/AO) (4,5).…”

“…Stability-based diagnostic algorithms have been developed in the last few decades, due to a fairly comprehensive consensus opinion that fractures with a stable ankle mortise can be treated conservatively, but unstable fractures are expected to have a better outcome with operative treatment (6,7). The exclusion of so-called dynamic instability is thought to be particularly important when the most common type of ankle fracture, known as a supination-external rotation (SER) (1) and classified as OTA/AO 44-B (4,5), comprises an isolated lateral malleolus fracture without medial widening (6,7).…”