Classifications
Exam Questions
and Complete
Solutions Graded
Denning [Date] [Course title]
,OPEN FRACTURES - GUSTILLO AND ANDERSON - Answer: Type I (treat with ancef/keflex)- Wound <1cm
long, little ST damage, no sign of crush, simple/transverse/oblique fx w/ little comminution
Type II (add clindamycin)- Wound >1cm long, minor ST damage, slight/moderate crush injury, moderate
comminution
Type III (add aminoglycoside)- Extensive ST injury, high degree of comminution
IIIa - ST coverage of bone is adequate, trauma high-energy
IIIb - extensive ST damage requiring free-flap for coverage, assoc w/ periosteal stripping and ST
contamination
IIIc - any open fx w/ arterial injury requiring immediate repair
CLOSED FRACTURES - ROCKWOOD AND GREEN - Answer: Type I - Direct Trauma; closed fx by a direct
blow
A - Tapping Fx; low velocity blow, little comminution and little ST damage
B - Crush Fx; high velocity blow, extensive ST injury & comminution
Type II - Indirect Trauma; closed fx from force acting distant to the fx site
A - Traction Fx; transverse avulsion fx at site of tendon or ligament
B - Angulation Fx; transverse fx caused by bending of long bone
C - Spiral Fx; oblique fx 45° from axis of long bone, by rotational force
D - Compression Fx; impaction of shaft into soft cancellous bone
E - Angulation and Axial Compression Fx; transverse fx w/ butterfly fragment
F - Angulation and Rotation Fx; causes oblique fx lines
FRACTURE STABILITY - CHARNLEY - Answer: Most Stable - transverse fx
Potentially Stable - short obliqe fx, <45° from transverse
Least Stable - long oblique, >45°, comminuted fxs
NON-UNIONS - WEBER & CECH - Answer: Hypertrophic Type
(vascular, reactive)
1. Elephant's foot
2. Horse's hoof
, 3. Oligotrophic
Atrophic Type
(avascular, non-reactive)
1. Torsion wedge
2. Comminuted
3. Defect
4. Atrophic
1ST MPJ DISLOCATIONS - JAHSS CLASSIFICATION - Answer: Type I - Hallux/sesamoid dislocation, no
disruption of sesamoid apparatus, irreducible to closed reduction.
Type IIa - closed reducible, disrupted intersesamoidal ligament
Type IIb - closed reducible, transverse fx of sesamoids
Type IIc - open reduction, both IIa and IIb.
REGNAULD CLASSIFICATION - Answer: Type I - "Jones Fracture," transverse fx of diaphyseal /
metaphyseal junction. Healing potential is poor.
Type II - Intraarticular avulsion fx
Type III - Extraarticular avulsion fxIV - Intraarticular comminuted fx
Type V - (peds) Extraarticular fx through epiphysis
TORG CLASSIFICATION - Answer: Type I - Acute Jones fx
Type II - Delayed-union Jones or diaphyseal stress fx
Type III - Non-union Jones or diaphyseal stress fx
Stewart CLASSIFICATION - Answer: Type Ia - Non-displaced Jones fx
Type Ib - Displaced or comminuted Jones fx
Type II - Delayed or non-union Jones fx
Type IIIa - Non-articular styloid process fx