UPMC classification

8/11/2019 UPMC classification

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CCLASSIFICATIONLASSIFICATIONSSYSTEMSYSTEMS

EPONYMS

Bosworth Frx Fibular frx with posterior dislocation of talus.

Named after David Bosworth, an NY orthopedic surgeon who

introduced streptomycin for bone and oint !B.Chopart Frx Frx"dislocation involving the midtarsal oints.

Francois #hopart, surgeon in $aris, whose amps through

midtarsal oint was effective and resisted infection.

Cotton Frx Frx of lateral and medial malleolus and frx ofposterior process of tibia. Fredrich #otton, Boston surgeon,

who illustrated his own %&%' boo(,Dislocations and

Fractures.Danis-Weber Cassi!i"ation First described by )obertDanis, Belgian surgeon, in %&*&. +is pioneering wor( in

internal fixation led colleague aurice -. uller to assemble

a study group in %&/ for clinical trials of internal fixation

0rbeitsgemeinschaft fur 1steosynthesefragen 2013. 4ater, thesystem was imodified by Bernhard 5eorg 6eber a prominent

orthopedic surgeon in 7wit8erland.D#p#$tren Frx Distal fibular frx above lateral malleolus w"

associated tear of tibiofibular and deltoid ligament. 4ateral

displacement of talus and possible medial malleolus frx.5uillaume Dupuytren, 9greatest French surgeon and meanest

of men: of the %&thcentury, has his name associated w" %;

different conditions"operations.Essex-Lopresti Cassi!i"ation $eter 5ordon -ssex>, was an expert in parachuting inuries.Freiber% In!ra"tion )efers to deformity of head of secondor third metatarsal from 0?N, presumably secondary to

trauma. Named after 0lbert +enry Freiberg, $rofessor of

1rthopedic 7urgery at the @niversity of #incinnati, 1+>1.&ossein Frx ?, and #arl 7chlatter was a professor of

surgery in Curich 7wit8erland.

Pott Frx $artial dislocation of the an(lew" frx of the distal fibular shaft and ruptureof the medial ligaments. $ercival $ott was a

leading surgeon in 4ondon and described

!B in the spine 2$ott=s Disease3.Sater-(arris Cassi!i"ation )obert Bruce 7alter, currentlya #anadian surgeon at the @niversity of !oronto. )obert

+arris is another #anadian orthopedic surgeon at the

@niversity of !oronto.Shepar+ Frx !he lateral tubercle of the posterior process ofthe talus frx may simulate an os trigonum. Francis A. 7hepard

was from -ngland, but emigrated to #anada to become a

prominent surgeon.

Tia#x Frx 0n avulsion inury of the anterior tibial tubercleat the attachment of the distal anterior

tibiofibular ligament. $aul Aules !illaux,

French surgeon and anatomix, never

clinically described frx, but did exuisiteanatomic studies detailing results of

experimentally produced an(le inuries.

OPENF,ACT,ES. &STILLOANDANDE,SON


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T$pe I 6ound %cm long, little 7! damage, no sign of

crush, simple"transverse"obliue fx w" little comminutionT$pe II 6ound E%cm long, minor 7! damage,

slight"moderate crush inury, moderate comminutionT$pe III -xtensive 7! inury, high degree of comminution

IIIa 7! coverage of bone is adeuate, trauma high>a and >>b.

Ja,ss %! Foot An/le 198*;1!15#)1

P,E-DISLOCATIONSYND,OME. Y

STA&EI 7ubtle, mild edema with dorsal and plantar to lesser!$A. 0lignment of the digit unchanged compared to the

contralateral digit.STA&EII ild to oderate edema. Noticeable deviation of

the digit. 4oss of toe purchase, noticeable in weight bearingSTA&EIII oderate edema. $ronounced

deviation"subluxationu.redislocation s:ndrome. rogressie sulu,alangeal 'oint.JA%A0 A>ril )**) A>r;9)(4!18)#99

6T(METATA,SALBASEF,ACT,ES. STEWA,TCLASSIFICATION

T$pe I 9Aones Fracture,: transverse fx of diaphyseal "

metaphyseal unction. +ealing potential is poor.T$pe II >ntraarticular avulsion fx

T$pe III -xtraarticular avulsion fxT$pe I3 >ntraarticular comminuted fxT$pe 3 2peds3 -xtraarticular fx through epiphysis

!ype > !ype >> !ype >>> !ype >? !ype ?

Ste3art &. Jones? racture! racture o t,e ase o t,e it, metatarsal. -lin rt,o> 196*;16!19*#198

NA3ICLA,F,ACT,ES. WATSON7'ONESCLASSIFICATION

T$pe I 0vulsion fx off tuberosity by $! tendonT$pe II Dorsal lip fx, may resemble os supranaviculareT$pe IIIa !ransverse fx, non


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ardcastle 0 et al. &n'uries to t,e tarsometatarsal 'oint. &ncidence0 -lassiication and

+reatment.. J Bone and Joint Surg 198); 64B("!"49#56.

MYE,SONMODIFICATION

TYPEA . !otal >ncongruityTYPEB5 $artial >ncongruity, edial DislocationTYPEB5 $artial >ncongruity, 4ateral DislocationTYPEC5 Divergent, $artial DisplacementTYPEC: Divergent, !otal Displacement

%:erson0 %0 FA&0 6; ))80 1986

CALCANEALF,ACT,ES

Si%ns 4 S$;pto;s


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T$pe IIIb same as >>>a, but comminuted.

T$pe I3a4b same as type >>>, but w" 7!A involvement.

T$pe 3a intraarticular 7!A fx w" comminution and

depression of the articular segment.T$pe 3b intraarticular fx of the calcaneo

stud: one ,undred ort:#si< >atients. JA%A 196"; 184! 9)*#9)"

ESSE=-LOP,ESTICLASSIFICATION

Ton%#e T$pe . Axia oa+ panter!exe+

'oint T$pe . Axia Loa+ Dorsi!exe+

sseresti ! +,e mec,anism0 reduction tec,niue0 and results in ractures o t,e os

calcis0 1951#5). -lin rt,o> 199" %a:; "#16

SANDE,8SCLASSIFICATION

2NoteG !his classification system reuires the fracture to bevisuali8ed w" coronal #! scan.3T$pe I20, B, and #3 one part, nondisplaced articular fx.

T$pe II20, B, and #3 two part fx of posterior facet.

T$pe III20B, 0#, and B#3 three part fx w" central

depressed segment.T$pe I3 comminuted fx of posterior facet.

the )owe system. For intraeratie treatment in 1)* dis>laced intraarticular

calcaneal ractures. esults using a >rognostic com>uted tomogra>,: scan classiication

-lin rt,o> 199" %a:; 87#95


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TALA,NEC2F,ACT,ES. (AW2IN8SCLASSIFICATION

!hese fxs are usually seen in ?0s or shortF

#oronal

7agittal

+ori8ontal

&ro#p III $osterior !ubercle Fracture 7hepherd=s Fx

&ro#p I3 4ateral $rocess Fracture 2Feldborg3&ro#p 3 #rush inury highly comminuted

Sne>>en 0 -,rstensen SB0 $rogsoe 0 et al! Fractures o t,e od: o t,e talus. Actart,o> Scand 48! "17#")40 1977

LATE,ALTALA,P,OCESS- (AW2IN8SCLASSIFICATION

T$pe I 7imple fx from 0A articulation to 7!AT$pe II #omminuted fx involving calcaneal fibular

articulationsT$pe III #hip fx of anterior"inferior portion of lat process

a3/ins C2! Fractures o t,e lateral >rocess o t,e talus. J Bone Joint Surg 1965; 47A!

117*#1175

EPIP(YSEALF,ACT,ES. SALTE,-(A,,ISCLASSIFICATION


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T$pe I shearing force, separation of epiphysis frommetaphysis w"o fx, seen at birth and in young children.T$pe II fx line extends through physis and exits metaphysis.

7hearing or avulsion force, P !hurston +olland sign.Th#rston (oan+ Si%n triangle shaped metaphyseal fx.T$pe III fx line extends through physis and exits epiphysis

2intraarticular3. Due to shearing force.

T$pe I3 intraarticular fx through epiphysis, physis, andmetaphysis. $rognosis is poor.T$pe 3 compression fx, compacted germinal cells of physis

die and cause premature closure. $oor prognosis.T$pe 3I2)ang3 < contusion of perichondral ring of physis,

acts li(e type ? if a bony bridge develops prognosis good.T$pe 3II21gden3 epiphyseal fx not affecting physisT$pe 3III 21gden3 partial fx of metaphysis, growth linesT$pe I=21gden3 degloving loss of periosteum on diaphysis

B Salter0 arris &n'uries inoling t,e ei>,:seal >late. JBJS @ol 45. 196". > 587#

6")

DIAS-TAC(D'IANCLASSIFICATION

S#pination-In*ersion grade > 203S#pination-In*ersion grade >> 2B3

S#pination-Pantar!exion2#3

S#pination-Ext ,otation grade > 2D3S#pination-Ext ,otation grade >> 2-3Pronation-E*ersion-Ext ,otation2F3'#*enie Tia#x Fra"t#re 253

Tripanar Fra"t#re2+3

Dias CS0 +ac,d'ian %! ,:seal in'uries o t,e an/le in c,ildren. -lin rt,o> elat es

1978;1"6!)"*G)""

AN2LEF,ACT,ES- LA&E-(ANSENCLASSIFICATION

!he first word in this classification denotes the position of the

foot at time of inuryL the second word denotes the motion of

the leg. !he numerical grades w"in each class occur each inchronological order and relate to the severity of trauma.S#pination . A++#"tion

I transverse fx of the lateral malleolusII vertical fx of the medial malleolus

Pronation . Ab+#"tion

I )upture of deltoid ligament"medial malleolar fxII )upture of ant inferior tibio!F4 intactT$pe I3 #omplete 0n(le Diastasis w" talus dislocated

superiorly, wedged between the tibia and fibula.d3ards S0 DeCee -. An/le diastasis 3it,out racture. Foot An/le 1984;4!"*5#1)

MIDTA,SALF,ACT,ES. MAIN4 'OWETT

51Medial Force2K'O3precursor to 7!A dislocation

T$pe A< fla(e fx of dorsal talus or navicular and lateralcalcaneus or cuboidT$pe B< medial displacement of FF w" !N and ## ointsT$pe C< FF rotates medially around interosseous

talocalcaneal lig w" !N disassociation and ##A intact:1Longitudinal Force2*'O3 worst prognosis of non


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T$pe B< !NA displaces laterally w" comminution of ##A1Plantar Force2IO3T$pe A ,ia0 a! B

Saunders -o; 197*

AN2LESP,AIN. LEAC(CLASSIFICATION


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5stDe%ree partial or complete tear of 0!F4:n+De%ree partial or complete tear of 0!F4 #F4@r+De%ree partial or complete tear or 0!F4, #F4, $!F4

Ceac, 0 Hai/i 0 aul 20 Stoc/el J. Secondar: reconstruction

o t,e lateral ligaments o t,e an/le. -lin rt,o> 198); ))6!169#7"

AN2LESP,AIN. ,ASMSSENCLASSIFICATION

Sta%e I rupture of 0!F4Sta%e II rupture of superficial fibers of $!F4Sta%e III rupture of #F4

Sta%e I3 rupture of deep fibers of $!F4asmussen ! Stailit: o t,e an/le 'oint. Anal:sis o t,e unction and traumatolog: o

t,e an/le ligaments. Acta rt,o> Scand Su>>l 1985; )11! 1#75

ST' DISLOCATION

Subtalar joint dislocations are commonlyclassifed accordingto the position o the oot inrelation to the talusT$pe I edial dislocation of 7!A or 90cuired clubfoot:T$pe II 4ateral dislocation of 7!A or 90cuired flatfoot:T$pe III 0nterior"posterior dislocation of 7!A

Buc/ing,am Jr. Sutalar dislocation o t,e oot. J +rauma 197";1"!75"#765

S+AKS D-! Sutalar dislocation o t,e oot. J Bone Joint Surg 30:4)70 19"5.

PTTD . 'O(NSONANDST,OM

Sta%e I edial pain, tenosynovitis, mild wea(ness on heeldiopathicT$pe I3 )upture secondary to mechanical dysfunction

%ueller +J! Acuired latoot secondar: to tiialis >osterior d:sunction!

Biomec,anical as>ects. J. Foot Surg. "*!)0 1991

PTTD . CONTICLASSIFICATION0M,I1

Sta%e I 1ne or two fine, longitudinal tearsSta%e II >ntramural degeneration, variable diameter, wide

longitudinal tears

Sta%e III 7carring in tendon, complete tear

-onti S et al. -linical signiicance o %& in >re#o>eratie >lanning or reconstruction o

>osterior tiial tendon ru>tures. Foot and An/le 199); 1"!)*8

PTTD . ,OSENBE,&CLASSIFICATION0M,I1

Sta%e I +ypertrophic tears in tendon 2appears bulbous3Sta%e II 0trophic tearsSta%e III #omplete tear

osenerg LS0 et al! u>ture o >osterior tiial tendon!

-+ and % imaging 3it, surgical correlation.

adiolog: 1988;169!))9#)"5

AC(ILLES,PT,E. 2WADA

CLASSIFICATION

!he achilles is an conoined tendon thatinternally rotates to insertion. >t has a

9watershed: area at ;


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at the area, with a palpable gap. $atients may present with an

antalgic gait.T$pe I . $artial rupture of tendonT$pe II #omplete rupture of tendon, Kcm gapT$pe III #omplete rupture, Kture. -lin odiatr %ed Surg

1995;1)! 6""#5)

PE,ONEALTENDONDISLOCATION- EC2E,T4 DA3IS

&ra+e I retinaculum ruptured from cartilaginous lip to

posterior lateral malleolus&ra+e II distal %eroneal retinaculum. J Bone Joint Surg

Am 1976 Jul; 58(5! 67*#)

OSTEOMYELITIS . BC2(OL?

T$pe I wound induced osteomyelitisIa open fx w" complete discontinuity Ib penetrating wound

I" posteutic

considerations and unusual as>ects. H ngl J %ed 197* Jan )); )8)(4! 198#)*6

OSTEOMYELITIS . PAT?A2ISCLASSIFICATION

?one I Distal metatarsal nec( 2most common3?one II ! nec( to !A 2least common3?one III calcaneus or talus

ata/is J0 -al,oun J0 -iern: 20 oltom 0 %ader J+0 Helson -C S:m>osium!

-urrent -once>ts in t,e %anagement o steom:elitis. #ontemporary 1rthopaedics0

)8()! 157#185 >assim0 1994

TA,SALCOALITIONS. DOWNEY

A '#*enie 0Osseo#s I;;at#rit$1

T$pe I extra


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T$pe II complete webbing to ends of digitsT$pe III simple syndactyly, no phalangeal involvementT$pe I3 complicated, phalangeal bones appear abnormal

Dais JS0 2erman J (19"* S:ndact:lism. Arc, Surg )1 ! ")#. 75. 5

C(A,COTFOOT. EIC(EN(OLT?H YH S(IBATA

Sta%e / . swelling, warmth, w" oint instabilitySta%e I destructive phase w" oint laxity, subluxation, and

osteochondral fragmentationSta%e II coalescenceL absorption of debris and fusion oflarger fragments to adacent boneSta%e III remodelingL revasculari8ation and remodeling of

bone and fragmentsic,en,ol SH. -,arcot Joints. S>ringield! -,arles -. +,omas0 1966

u0 aluation and +reatment o Stage * -,arcot?s Heuroart,ro>at,: o t,e Foot and

An/le. JA%A 9)(4! )1*#))*0 )**)

S,iata0 esults o art,rodesis o t,e an/le in le>rotic neuro>at,: >ts. JBJS 199*

C(A,COTFOOTDEFO,MITY. ON3LEE

Pattern A $lanoatients. +,esis. +,e net,erlands! Kniersit: o Ceiden0 1998.

(ALL=LIMITS7,I&IDS. D,A&OH O,LOFFH AND'ACOBS

&ra+e I Functional limitus+allux euinus"flexus, plantar subluxation of proximal phalanx, $-, no

DAD, hyperextension of +>$A, pronatory architecture, oint )1 normal

N6B, but is limited on 6B.

&ra+e II . 0daptationL proliferative"destructive oint changeFlattening of %st! head, pain on end )1, passive )1 limited,

osteochondral defect"cartilage fibrillation erosion, small dorsal exostosis,

subchondral eburnation, periarticular lipping or phalanx base and % st! head

&ra+e III< Aoint deterioration"arthritis, established arthrosis7evere flattening of %st! head, osteophytosis dorsally, nonle< regional >ain s:ndrome t:>e &! use o t,e international association

or t,e stud: o >ain diagnostic criteria deined in 1994. -lin J. ain 18! )*7#)150 )**).

NE,3EIN',Y. SEDDEN

Ne#ropraxia interruption of nerve impulse due to extrinsicpressure, resulting in pinpoint segmental demyelinationAxonot;esis . severance of individual nerve fibers, resulting

in partial severance of nerveNe#rot;esis complete severance of nerve, resulting inwallerian degenerationSeddon J! +,ree t:>es o nere in'uries. Brain 194"; 66! )"7

NE,3EIN',Y. SNDE,LANDCLASSIFICATION

5stDe%ree disruption of nerve impulses w"o wallerian

degeneration:n+De%ree disruption of axon, w" wallerian degeneration

distal to the point of inury@r+De%ree fibrosis of nerve, regrowth w" fusiform swellingthDe%ree incomplete severance of nerve6thDe%ree < complete severance of nerveSunderland S! A classiication o >eri>,eral nere in'uries >roducing loss o unction.

Brain 74!491#5160 1951

FOOTLCE,ATION. WA&NE,

&ra+e / 7(in is intact, no open lesions.&ra+e 5 7(in only lesion, large or small, dirty or clean&ra+e : Deeper lesion involving tendon, muscle, or bone&ra+e @ 5rade ; w" infection 2abscess, osteomyelitis3&ra+e $artial gangrene in the forefoot

&ra+e 6 -ntire foot is gangrenous, no procedures possibleagner F Jr. +,e diaetic oot. rt,o>edics 1987;1*!16"#7)

TSA CLASSIFICATION

&ra+e / pre or post ulcerative lesion, epitheliali8ed&ra+e 5 superficial wound, w" out tendon, capsule or bone&ra+e : wound penetrating to capsule, tendon, or bone&ra+e @ wound penetrating to bone or ointT$pe A #lean, vascular woundT$pe B >nfected, vascular woundT$pe C #lean, ischemic woundT$pe D >nfected, ischemic wound

Caer: CA0 Armstrong D20 ar/less CB. -lassiication o diaetic oot 3ounds. J Foot

An/le Surg. 1996 Ho#Dec;"5(6!5)8#"1
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=8986890&query_hl=5&itool=pubmed_docsumhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=8986890&query_hl=5&itool=pubmed_docsum


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B,NCLASSIFICATION

5stDe%ree superficial, involving outer layer of s(in,

erythema, no blisters:n+De%ree superficial or deep, may or may not have blisters

assoc w" erythema, anesthetic@r+De%ree fullncludes electric burns, radiation

burns, and frostbite. #an lead to physeal growth arrest.Minor %'O !B70 in adultsL O !B70 in children orelderlyL ;O full -lin Hort, Am

14!675#6970 198"

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