FIBULA

TIBIA/FIBULA

Location: Proximal segment (41)

BONE: TIBIA/FIBULA (4)

Types: A. Extra-articular (41-A)

Groups: Tibia/fibula, proximal, extra-articular 1. Avulsion 2. Metaphy(41-A1) seal simple (41-A2)

(41-A) 3. Metaphyseal multifragmentary (41-A3)

© 2007 Lippincott Williams & Wilkins

B. Partial articular (41-B)

Tibia/fibula, proximal, partial articular (41-B) 2. Pure de1. Pure split 3. Split depression (41-B1) pression (41-B2) (41-B3)

C. Complete articular (41-C)

Tibia/fibula, proximal, complete articular (41-C) 1. Articular 3. Articular 2. Articular simple, metamultifragsimple, metaphyseal simple physeal multimentary (41-C1) (41-C3) fragmentary (41-C2)

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Tibia/Fibula

J Orthop Trauma • Volume 21, Number 10 Supplement, November/December 2007

Subgroups and Qualifications: Tibia/fibula, proximal, extra-articular, avulsion (41-A1) 2. Of tibial tuberosity (41-A1.2) 1. Of fibular head (41-A1.1)

3. Of cruciate insertion (41-A1.3) (1) anterior (2) posterior

A1

Tibia/fibula, proximal, extra-articular, simple metaphysis (41-A2) 1. Oblique in frontal plane (41-A2.1) 2. Oblique in sagittal plane (41-A2.2)

3. Transverse (41-A2.3)

A2

Tibia/fibula, proximal, extra-articular, multifragmentary metaphysis (41-A3) 2. Fragmented wedge (41-A3.2) 1. Intact wedge (41-A3.1) (1) lateral (1) lateral (2) medial (2) medial

3. Complex (41-A3.3) (1) slightly displaced (2) significantly displaced

A3

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J Orthop Trauma • Volume 21, Number 10 Supplement, November/December 2007 Tibia/fibula, proximal, partial articular, split (41-B1) 1. Of lateral surface (41-B1.1) 2. Of medial surface (41-B1.2) (1) marginal (1) marginal (2) sagittal (2) sagittal (3) frontal anterior (3) frontal anterior (4) frontal posterior (4) frontal posterior

Tibia/Fibula

3. Oblique, involving the tibial spines and 1 of the surfaces (41-B1.3) (1) lateral (2) medial

B1

Tibia/fibula, proximal, partial articular, depression (41-B2) 1. Lateral total (41-B2.1) 2. Lateral limited (41-B2.2) (1) 1 piece (1) peripheral (2) mosaic-like (2) central (3) anterior (4) posterior

3. Medial (41-B2.3) (1) central (2) anterior (3) posterior (4) total

B2

Tibia/fibula, proximal, partial articular, split depression (41-B3) 2. Medial (41-B3.2) 1. Lateral (41-B3.1) (1) antero-lateral depression (1) antero-lateral depression (2) postero-lateral depression (2) postero-lateral depression (3) antero-medial depression (3) antero-medial depression (4) postero-medial depression (4) postero-medial depression

3. Oblique involving the tibial spines and 1 of the surfaces (41-B3.3) (1) lateral (2) medial

B3


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Tibia/Fibula


Tibia/fibula, proximal, complete articular, simple articular, simple metaphysis (41-C1) (1) intact anterior tibial tubercle and intercondylar eminence (2) anterior tibial tubercle involved (3) intercondylar eminence involved 2. 1 condyle displaced (41-C1.2) 3. Both condyles displaced (41-C1.3) 1. Slight displacement (41-C1.1)

C1

Tibia/fibula, proximal, complete articular, articular simple, metaphysis multifragmentary (41-C2) 3. Complex (41-C2.3) 2. Fragmented wedge (41-C2.2) 1. Intact wedge (41-C2.1) (1) lateral (1) lateral (2) medial (2) medial

C2

Tibia/fibula, proximal, complete articular, articular multifragmentary (41-C3) (1) metaphyseal simple (2) metaphyseal lateral wedge (3) metaphyseal medial wedge (4) metaphyseal complex (5) metaphysio-diaphyseal complex 1. Lateral (41-C3.1) 2. Medial (41-C3.2)

3. Lateral and medial (41-C3.3)

C3

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Tibia/Fibula

Location: Diaphyseal segment (42)


Types: A. Simple (42-A)

B. Wedge (42-B)

Groups: Tibia/fibula, diaphyseal, simple (42-A) 1. Spiral (42-A1) 2. Oblique 3. Transverse ⱖ30°) (42-A2) (⬍ (ⱖ ⬍30°) (42-A3)


Tibia/fibula, diaphyseal, wedge (42-B) 1. Spiral wedge 2. Bending 3. Frag(42-B1) mented wedge (42-B2) wedge (42-B3)

C. Complex (42-C)

Tibia/fibula, diaphyseal, complex (42-C) 3. Irregular 1. Spiral 2. Segmented (42-C3) (42-C1) (42-C2)

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Tibia/Fibula


Subgroups and Qualifications: Tibia/fibula, diaphyseal, simple, spiral (42-A1) (1) proximal zone (2) middle zone (3) distal zone 1. Fibula intact (42-A1.1) 2. Fibula fracture at different level (42-A1.2)

3. Fibula fracture at same level (42-A1.3)

A1

Tibia/fibula, diaphyseal, simple, oblique (ⱖ30°) (42-A2) (1) proximal zone (2) middle zone (3) distal zone 1. Fibula intact (42-A2.1) 2. Fibula fracture at different level (42-A2.2)


A2

Tibia/fibula, diaphyseal, simple, transverse (<30°) (42-A3) (1) proximal zone (2) middle zone (3) distal zone 1. Fibula intact (42-A3.1) 2. Fibula fracture at different level (42-A3.2)


A3

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J Orthop Trauma • Volume 21, Number 10 Supplement, November/December 2007 Tibia/fibula, diaphyseal, wedge, spiral (42-B1) (1) proximal zone (2) middle zone (3) distal zone 1. Fibula intact (42-B1.1) 2. Fibula fracture at different level (42-B1.2)

Tibia/Fibula

3. Fibula fracture at same level (42-B1.3)

B1

Tibia/fibula, diaphyseal, wedge, bending (42-B2) (1) proximal zone (2) middle zone (3) distal zone 2. Fibula fracture at different level 1. Fibula intact (42-B2.1) (42-B2.2)


B2

Tibia/fibula, diaphyseal, wedge fragmented (42-B3) (1) proximal zone (2) middle zone (3) distal zone 2. Fibula fracture at different level 1. Fibula intact (42-B3.1) (42-B3.2)


B3


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Tibia/Fibula


Tibia/fibula, diaphyseal, complex, spiral (42-C1) (1) pure diaphyseal (2) proximal diaphysio-metaphysis (3) distal diaphysio-metaphysis 1. With 2 intermediate fragments 2. With 3 intermediate fragments (42-C1.1) (42-C1.2)

3. With more than 3 intermediate fragments (42-C1.3)

C1

Tibia/fibula, diaphyseal, complex segmental (42-C2) 2. With an intermediate segmental 1. With an intermediate segmental and additional wedge fragment(s) fragment (42-C2.1) (42-C2.2) (1) pure diaphyseal (1) pure diaphyseal (2) proximal diaphysio-metaphyseal (2) proximal diaphysio-metaphyseal (3) distal diaphysio-metaphyseal (3) distal diaphysio-metaphyseal (4) oblique lines (4) distal wedge (5) transverse and oblique lines (5) 3 wedges, proximal and distal

3. With 2 intermediate segmental fragments (42-C2.3) (1) pure diaphyseal (2) proximal diaphysio-metaphyseal (3) distal diaphysio-metaphyseal

C2

Tibia/fibula, diaphyseal, complex, irregular (42-C3) 1. With 2 or 3 intermediate fragments 2. Limited shattering (⬍ ⬍4cm) (42-C3.1) (42-C3.2) (1) 2 intermediate fragments (2) 3 intermediate fragments

⬎4cm) 3. Extensive shattering (⬎ (42-C3.3) (1) pure diaphyseal (2) proximal diaphysio-metaphyseal (3) distal diaphysio-metaphyseal

C3

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Types: A. Extra-articular (43-A)

Groups: Tibia/fibula, distal, extra-articular (43-A) 1. Metaphyseal 2. Metaphy3. Metaphysimple (43-A1) seal complex seal wedge (43-A3) (43-A2)


Tibia/Fibula

Location: Distal segment (43)

B. Partial articular (43-B)

Tibia/fibula, distal, partial articular (43-B) 1. Pure split 3. Multifragmen2. Split de(43-B1) tary depression pression (43-B3) (43-B2)

C. Complete articular (43-C)

Tibia/fibula, distal, complete articular (43-C) 2. Articular 1. Articular 3. Articular simple, metasimple, metamultifragmenphysis multiphysis simple tary (43-C3) fragmentary (43-C1) (43-C2)

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Tibia/Fibula


Subgroups and Qualifications: Tibia/fibula, distal, extra-articular, simple (43-A1) (1) fibula intact (2) simple fracture of fibula (3) multifragmentary fracture of fibula (4) bifocal fracture of fibula 1. Spiral (43-A1.1) 2. Oblique (43-A1.2)

3. Transverse (43-A1.3)

A1

Tibia/fibula, distal, extra-articular, wedge (43-A2) (1) fibula intact (2) simple fracture of fibula (3) multifragmentary fracture of fibula (4) bifocal fracture of fibula 2. Anteromedial wedge (43-A2.2) 1. Posterolateral impaction (43-A2.1)

3. Extending into diaphysis (43-A2.3)

A2

Tibia/fibula, distal, extra-articular, complex (43-A3) (1) fibula intact (2) simple fracture of fibula (3) multifragmentary fracture of fibula (4) bifocal fracture of fibula 1. With 3 intermediate fragments 2. More than 3 intermediate frag(43-A3.1) ments (43-A3.2)

3. Extending into diaphysis (43-A3.3)

A3

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Tibia/fibula, distal, partial articular, pure split (43-B1) (1) fibula intact (2) simple fracture of fibula (3) multifragmentary fracture of fibula (4) bifocal fracture of fibula 1. Frontal (43-B1.1) 2. Sagittal (43-B1.2) (5) anterior (5) lateral (6) posterior (Volkmann) (6) medial (medial malleolus)

Tibia/Fibula

3. Metaphyseal multifragmentary (43-B1.3)

B1

Tibia/fibula, distal, partial articular, split depression (43-B2) (1) fibula intact (2) simple fracture of fibula (3) multifragmentary fracture of fibula (4) bifocal fracture of fibula 1. Frontal (43-B2.1) 2. Sagittal (43-B2.2) (5) anterior (5) lateral (6) posterior (6) medial

3. Of the central fragment (43-B2.3)

B2

Tibia/fibula, distal, partial articular, depression (43-B3) (1) fibula intact (2) simple fracture of fibula (3) multifragmentary fracture of fibula (4) bifocal fracture of fibula 1. Frontal (43-B3.1) 2. Sagittal (43-B3.2) (5) anterior (5) lateral (6) posterior (6) medial

3. Metaphyseal, multifragmentary (43-B3.3)

B3


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Tibia/Fibula


Tibia/fibula, distal, complete articular, articular simple, metaphyseal simple (43-C1) (1) fibula intact (2) simple fracture of fibula (3) multifragmentary fracture of fibula (4) bifocal fracture of fibula 1. Without impaction (43-C1.1) 2. With epiphyseal depression (5) frontal plane (43-C1.2) (6) sagittal plane

3. Extending into diaphysis (43-C1.3)

C1

Tibia/fibula, distal, complete articular, articular simple, multifragmentary metaphysis (43-C2) (1) fibula intact (2) simple fracture of fibula (3) multifragmentary fracture of fibula (4) bifocal fracture of fibula 3. Extending into diaphysis (43-C2.3) 2. Without asymmetric impaction 1. With asymmetric impaction (43-C2.2) (43-C2.1) (5) frontal plane split (6) sagittal plane split

C2

Tibia/fibula, distal, complete articular, articular multifragmentary (43-C3) (1) fibula intact (2) simple fracture of fibula (3) multifragmentary fracture of fibula (4) bifocal fracture of fibula 2. Epiphysio-metaphyseal (43-C3.2) 1. Epiphyseal (43-C3.1)

3. Epiphysio-metaphysio-diaphyseal (43-C3.3)

C3

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Types: A. Infrasyndesmotic lesion (44-A)

Groups: Tibia/fibula, malleolar, infrasyndesmotic lesions (44-A) 3. With 2. With me1. Isolated postero-medial dial malleolar (44-A1) fracture fracture (44-A3) (44-A2)


Tibia/Fibula

Location: Malleolar segment (44)

B. Transsyndesmotic fibula fracture (44-B)

Tibia/fibula, malleolar, transsyndesmotic fibula fracture (44-B) 2. With me1. Isolated 3. With medial lesion (44-B1) dial lesion (44-B2) and Volkmann (fracture of the posterolateral rim) (44-B3)

C. Suprasyndesmotic lesion (44-C)

Tibia/fibula, malleolar, suprasyndesmotic (44-C) 1. Simple dia2. Multifragphyseal fibular mentary fracfracture (44-C1) ture of fibular diaphysis (44-C2)

3. Proximal fibula (44-C3)

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Tibia/Fibula


Subgroups and Qualifications: Tibia/fibula, malleolar, infrasyndesmotic, isolated (44-A1) 2. Avulsion of tip of lateral malleolus 1. Rupture of lateral collateral (44-A1.2) ligament (44-A1.1)

3. Transverse fracture of lateral malleolus (44-A1.3)

A1

Tibia/fibula, malleolar, infrasyndesmotic lesion with medial malleolar fracture (44-A2) (1) transverse (2) oblique (3) vertical 1. Rupture of lateral collateral 2. Avulsion of tip of lateral malleolus 3. Transverse fracture of lateral malleligament (44-A2.1) (44-A2.2) olus (44-A2.3)

A2

Tibia/fibula, malleolar, infrasyndesmotic lesion with postero-medial fracture (44-A3) 2. Avulsion of tip of lateral malleolus 1. Rupture of lateral collateral (44-A3.2) ligament (44-A3.1)

3. Transverse fracture of lateral malleolus (44-A3.3)

A3

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Tibia/fibula, malleolar, transsyndesmotic, isolated (44-B1) 1. Simple (44-B1.1) 2. Simple with rupture of anterior syndesmosis (44-B1.2) (1) in substance (2) Chaput (anterior tibia) (3) Lefort (anterior fibula)

Tibia/Fibula

3. Multifragmentary (44-B1.3)

B1

Tibia/fibula, malleolar, transsyndesmotic fracture with medial lesion (44-B2) 1. Simple, rupture of medial collateral 2. Simple with fracture of medial and anterior syndesmosis (44-B2.1) malleolus and rupture of anterior syn(1) in substance desmosis (44-B2.2) (2) Chaput (1) in substance (3) Lefort (2) Chaput (3) Lefort

3. Multifragmentary (44-B2.3) (1) rupture of medial collateral ligament (2) fracture of medial malleolus

B2

Tibia/fibula, malleolar, transsyndesmotic with medial lesion and a Volkmann (fracture of posterolateral rim) (44-B3) (1) extra-articular avulsion (2) peripheral articular fragment (3) significant articular fracture 1. Fibula simple with medial collateral 2. Simple fibula fracture with fracture 3. Multifragmentary with fracture of ligament rupture (44-B3.1) of medial malleolus (44-B3.2) medial malleolus (44-B3.3)

B3


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Tibia/Fibula


Tibia/fibula, malleolar, susprasyndesmotic, simple diaphyseal fracture of fibula (44-C1) 2. With fracture of medial malleolus 3. With fracture of medial malleolus 1. Rupture of medial collateral (44-C1.2) and a Volkmann (Dupuytren) ligament (44-C1.1) (44-C1.3) (1) extra-articular avulsion (2) peripheral articular fragment (3) significant articular fragment

C1

Tibia/fibula, malleolar, suprasyndesmotic, multifragmentary fibular diaphyseal fracture (44-C2) 2. With fracture of medial malleolus 3. With fracture of medial malleolus 1. With rupture of medial collateral (44-C2.2) and a Volkmann (Dupuytren) ligament (44-C2.1) (44-C2.3) (1) extra-articular avulsion (2) peripheral articular fragment (3) significant articular fragment

C2

Tibia/fibula, malleolar, suprasyndesmotic, proximal fibular lesion (44-C3) (1) fracture through neck (2) fracture through head (3) proximal tibiofibular dislocation (4) rupture of medial collateral ligament (5) fracture of medial malleolus (6) articular fragment 1. Without shortening, without 2. With shortening, without Volkmann (44-C3.1) Volkmann (44-C3.2)

3. Medial lesion and a Volkmann (44-C3.3)

C3

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FIBULA

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