BONE: TIBIA/FIBULA (4) Location: Proximal segment (41)

Types:
A. Extra-articular (41-A)
Groups:
Tibia/fibula, proximal, extra-articular (41-A)
1. Avulsion
(41-A1)
2. Metaphy-
seal simple
(41-A2)
3. Metaphyseal
multifragmen-
tary (41-A3)
B. Partial articular (41-B) C. Complete articular (41-C)
2. Pure de-
pression
(41-B2)
2. Articular
simple, meta-
physeal multi-
fragmentary
(41-C2)
Tibia/fibula, proximal, partial articular (41-B)
1. Pure split
(41-B1)
Tibia/fibula, proximal, complete articular (41-C)
1. Articular
simple, meta-
physeal simple
(41-C1)
3. Split de-
pression
(41-B3)
3. Articular
multifrag-
mentary
(41-C3)
TIBIA/FIBULA
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Subgroups and Qualifications:
Tibia/fibula, proximal, extra-articular, avulsion (41-A1)
1. Of fibular head (41-A1.1) 2. Of tibial tuberosity (41-A1.2) 3. Of cruciate insertion (41-A1.3)
(1) anterior
(2) posterior
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)
Tibia/fibula, proximal, extra-articular, multifragmentary metaphysis (41-A3)
1. Intact wedge (41-A3.1)
(1) lateral
(2) medial
2. Fragmented wedge (41-A3.2)
(1) lateral
(2) medial
3. Complex (41-A3.3)
(1) slightly displaced
(2) significantly displaced
A1
A2
A3
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Tibia/fibula, proximal, partial articular, depression (41-B2)
1. Lateral total (41-B2.1)
(1) 1 piece
(2) mosaic-like
2. Lateral limited (41-B2.2)
(1) peripheral
(2) central
(3) anterior
(4) posterior
3. Medial (41-B2.3)
(1) central
(2) anterior
(3) posterior
(4) total
Tibia/fibula, proximal, partial articular, split (41-B1)
1. Of lateral surface (41-B1.1)
(1) marginal
(2) sagittal
(3) frontal anterior
(4) frontal posterior
2. Of medial surface (41-B1.2)
(1) marginal
(2) sagittal
(3) frontal anterior
(4) frontal posterior
3. Oblique, involving the tibial spines
and 1 of the surfaces (41-B1.3)
(1) lateral
(2) medial
Tibia/fibula, proximal, partial articular, split depression (41-B3)
1. Lateral (41-B3.1)
(1) antero-lateral depression
(2) postero-lateral depression
(3) antero-medial depression
(4) postero-medial depression
2. Medial (41-B3.2)
(1) antero-lateral depression
(2) postero-lateral depression
(3) antero-medial depression
(4) postero-medial depression
3. Oblique involving the tibial spines
and 1 of the surfaces (41-B3.3)
(1) lateral
(2) medial
B1
B2
B3
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2. Medial (41-C3.2)
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) 3. Lateral and medial (41-C3.3)
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
1. Slight displacement (41-C1.1) 2. 1 condyle displaced (41-C1.2) 3. Both condyles displaced (41-C1.3)
Tibia/fibula, proximal, complete articular, articular simple, metaphysis multifragmentary (41-C2)
1. Intact wedge (41-C2.1)
(1) lateral
(2) medial
2. Fragmented wedge (41-C2.2)
(1) lateral
(2) medial
3. Complex (41-C2.3)
C1
C2
C3
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BONE: TIBIA/FIBULA (4) Location: Diaphyseal segment (42)
Types:
A. Simple (42-A) B. Wedge (42-B) C. Complex (42-C)
Groups:
Tibia/fibula, diaphyseal, simple (42-A)
1. Spiral (42-A1)
2. Oblique
(30) (42-A2)
3. Transverse
(30)
(42-A3)
Tibia/fibula, diaphyseal, wedge (42-B)
1. Spiral wedge
(42-B1)
2. Bending
wedge (42-B2)
3. Frag-
mented
wedge (42-B3)
Tibia/fibula, diaphyseal, complex (42-C)
1. Spiral
(42-C1)
2. Segmented
(42-C2)
3. Irregular
(42-C3)
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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)
Tibia/fibula, diaphyseal, simple, oblique (30) (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)
3. Fibula fracture at same level
(42-A2.3)
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)
3. Fibula fracture at same level
(42-A3.3)
A1
A2
A3
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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)
3. Fibula fracture at same level
(42-B1.3)
2. Fibula fracture at different level
(42-B2.2)
3. Fibula fracture at same level
(42-B2.3)
Tibia/fibula, diaphyseal, wedge, bending (42-B2)
(1) proximal zone
(2) middle zone
(3) distal zone
1. Fibula intact (42-B2.1)
Tibia/fibula, diaphyseal, wedge fragmented (42-B3)
(1) proximal zone
(2) middle zone
(3) distal zone
1. Fibula intact (42-B3.1) 2. Fibula fracture at different level
(42-B3.2)
3. Fibula fracture at same level
(42-B3.3)
B1
B2
B3
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Tibia/fibula, diaphyseal, complex, irregular (42-C3)
1. With 2 or 3 intermediate fragments
(42-C3.1)
(1) 2 intermediate fragments
(2) 3 intermediate fragments
2. Limited shattering (4cm)
(42-C3.2)
3. Extensive shattering (4cm)
(42-C3.3)
(1) pure diaphyseal
(2) proximal diaphysio-metaphyseal
(3) distal diaphysio-metaphyseal
Tibia/fibula, diaphyseal, complex, spiral (42-C1)
(1) pure diaphyseal
(2) proximal diaphysio-metaphysis
(3) distal diaphysio-metaphysis
1. With 2 intermediate fragments
(42-C1.1)
2. With 3 intermediate fragments
(42-C1.2)
3. With more than 3 intermediate
fragments (42-C1.3)
Tibia/fibula, diaphyseal, complex segmental (42-C2)
1. With an intermediate segmental
fragment (42-C2.1)
(1) pure diaphyseal
(2) proximal diaphysio-metaphyseal
(3) distal diaphysio-metaphyseal
(4) oblique lines
(5) transverse and oblique lines
2. With an intermediate segmental
and additional wedge fragment(s)
(42-C2.2)
(1) pure diaphyseal
(2) proximal diaphysio-metaphyseal
(3) distal diaphysio-metaphyseal
(4) distal wedge
(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
C1
C2
C3
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BONE: TIBIA/FIBULA (4) Location: Distal segment (43)
Types:
A. Extra-articular (43-A) B. Partial articular (43-B) C. Complete articular (43-C)
2. Metaphy-
seal wedge
(43-A2)
3. Metaphy-
seal complex
(43-A3)
Groups:
Tibia/fibula, distal, extra-articular (43-A)
1. Metaphyseal
simple (43-A1)
Tibia/fibula, distal, partial articular (43-B)
1. Pure split
(43-B1)
2. Split de-
pression
(43-B2)
3. Multifragmen-
tary depression
(43-B3)
Tibia/fibula, distal, complete articular (43-C)
1. Articular
simple, meta-
physis simple
(43-C1)
2. Articular
simple, meta-
physis multi-
fragmentary
(43-C2)
3. Articular
multifragmen-
tary (43-C3)
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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)
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
1. Posterolateral impaction (43-A2.1) 2. Anteromedial wedge (43-A2.2) 3. Extending into diaphysis (43-A2.3)
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
(43-A3.1)
2. More than 3 intermediate frag-
ments (43-A3.2)
3. Extending into diaphysis (43-A3.3)
A1
A2
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)
(5) anterior
(6) posterior (Volkmann)
2. Sagittal (43-B1.2)
(5) lateral
(6) medial (medial malleolus)
3. Metaphyseal multifragmentary
(43-B1.3)
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)
(5) anterior
(6) posterior
2. Sagittal (43-B2.2)
(5) lateral
(6) medial
3. Of the central fragment (43-B2.3)
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)
(5) anterior
(6) posterior
2. Sagittal (43-B3.2)
(5) lateral
(6) medial
3. Metaphyseal, multifragmentary
(43-B3.3)
B1
B2
B3
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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
1. Epiphyseal (43-C3.1) 2. Epiphysio-metaphyseal (43-C3.2) 3. Epiphysio-metaphysio-diaphyseal
(43-C3.3)
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)
(5) frontal plane
(6) sagittal plane
2. With epiphyseal depression
(43-C1.2)
3. Extending into diaphysis (43-C1.3)
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
1. With asymmetric impaction
(43-C2.1)
(5) frontal plane split
(6) sagittal plane split
2. Without asymmetric impaction
(43-C2.2)
3. Extending into diaphysis (43-C2.3)
C1
C2
C3
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BONE: TIBIA/FIBULA (4) Location: Malleolar segment (44)
Types:
A. Infrasyndesmotic lesion (44-A)
Groups:
Tibia/fibula, malleolar, infrasyndesmotic lesions
(44-A)
1. Isolated
(44-A1)
2. With me-
dial malleolar
fracture
(44-A2)
3. With
postero-medial
fracture
(44-A3)
B. Transsyndesmotic fibula fracture (44-B) C. Suprasyndesmotic lesion (44-C)
2. With me-
dial lesion
(44-B2)
2. Multifrag-
mentary frac-
ture of fibular
diaphysis
(44-C2)
Tibia/fibula, malleolar, transsyndesmotic fibula frac-
ture (44-B)
1. Isolated
(44-B1)
Tibia/fibula, malleolar, suprasyndesmotic (44-C)
1. Simple dia-
physeal fibular
fracture (44-C1)
3. With me-
dial lesion
and
Volkmann
(fracture of
the postero-
lateral rim)
(44-B3)
3. Proximal
fibula (44-C3)
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Subgroups and Qualifications:
Tibia/fibula, malleolar, infrasyndesmotic, isolated (44-A1)
1. Rupture of lateral collateral
ligament (44-A1.1)
2. Avulsion of tip of lateral malleolus
(44-A1.2)
3. Transverse fracture of lateral malle-
olus (44-A1.3)
Tibia/fibula, malleolar, infrasyndesmotic lesion with medial malleolar fracture (44-A2)
(1) transverse
(2) oblique
(3) vertical
1. Rupture of lateral collateral
ligament (44-A2.1)
2. Avulsion of tip of lateral malleolus
(44-A2.2)
3. Transverse fracture of lateral malle-
olus (44-A2.3)
Tibia/fibula, malleolar, infrasyndesmotic lesion with postero-medial fracture (44-A3)
1. Rupture of lateral collateral
ligament (44-A3.1)
2. Avulsion of tip of lateral malleolus
(44-A3.2)
3. Transverse fracture of lateral malle-
olus (44-A3.3)
A1
A2
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)
3. Multifragmentary (44-B1.3)
Tibia/fibula, malleolar, transsyndesmotic fracture with medial lesion (44-B2)
1. Simple, rupture of medial collateral
and anterior syndesmosis (44-B2.1)
(1) in substance
(2) Chaput
(3) Lefort
2. Simple with fracture of medial
malleolus and rupture of anterior syn-
desmosis (44-B2.2)
(1) in substance
(2) Chaput
(3) Lefort
3. Multifragmentary (44-B2.3)
(1) rupture of medial collateral ligament
(2) fracture of medial malleolus
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
ligament rupture (44-B3.1)
2. Simple fibula fracture with fracture
of medial malleolus (44-B3.2)
3. Multifragmentary with fracture of
medial malleolus (44-B3.3)
B1
B2
B3
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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
Volkmann (44-C3.1)
2. With shortening, without
Volkmann (44-C3.2)
3. Medial lesion and a Volkmann
(44-C3.3)
Tibia/fibula, malleolar, suprasyndesmotic, multifragmentary fibular diaphyseal fracture (44-C2)
1. With rupture of medial collateral
ligament (44-C2.1)
2. With fracture of medial malleolus
(44-C2.2)
3. With fracture of medial malleolus
and a Volkmann (Dupuytren)
(44-C2.3)
(1) extra-articular avulsion
(2) peripheral articular fragment
(3) significant articular fragment
Tibia/fibula, malleolar, susprasyndesmotic, simple diaphyseal fracture of fibula (44-C1)
1. Rupture of medial collateral
ligament (44-C1.1)
2. With fracture of medial malleolus
(44-C1.2)
3. With fracture of medial malleolus
and a Volkmann (Dupuytren)
(44-C1.3)
(1) extra-articular avulsion
(2) peripheral articular fragment
(3) significant articular fragment
C1
C2
C3