New Classification System for Long-bone Fractures Supplementing the AO/OTA Classification

Full article available online at Healio.com/Orthopedics. Search: 20120426-26 This article describes a novel, clinically oriented classification system for long-bone fractures that is simple, reliable, and useful to predict treatment method, complications, and outcome. The reliability and memorability of the new classification were statistically tested and compared with the AO-Muller/Orthopaedic Trauma Association (AO/OTA) long-bone fracture classification. The proposed classification system was also clinically validated with a targeted pilot study designed for content and clinical outcome retrospectively reviewing 122 closed tibial shaft fractures, which were used as a representative paradigm of long-bone fractures. Statistical evaluation showed that the proposed classification system had improved interand intraobserver variation agreement and easier memorability compared with the AO/OTA classification system. The clinical validation study showed its predictive value regarding selection of treatment method, complication rate, and injury outcome. The proposed classification system proved simple, reliable, and memorable. Its clinical value appeared strong enough to justify the organization of larger studies for a complete assessment of its clinical usefulness for all long-bone fractures. Drs Garnavos, Kanakaris, Lasanianos, and Tzortzi are from the Orthopaedic Department, Evangelismos General Hospital, Athens, Greece; Dr Kanakaris is also from the Academic Department of Trauma and Orthopaedics, Leeds Teaching Hospitals, and Dr West is from Leeds Institute of Health Sciences, Centre for Epidemiology & Biostatistics, University of Leeds, Leeds, United Kingdom. Drs Garnavos, Kanakaris, Lasanianos, Tzortzi, and West have no relevant financial relationships to disclose. Correspondence should be addressed to: Christos Garnavos, MD, PhD, Orthopaedic Department, Evangelismos General Hospital, 5 Poseidonos Str, Glyfada 16674, Athens, Greece (cgarn@otenet.gr). doi: 10.3928/01477447-20120426-26 New Classification System for Long-bone Fractures Supplementing the AO/OTA Classification Christos Garnavos, MD, PhD; nikolaos k. kanakaris, MD, PhD; nikolaos G. lasanianos, MD, PhD, MsC; Paraskevi tzortzi, MD; robert M. West, PhD Figure 1: Topography of long-bone segments: D, distal; M, middle; MD, middle to distal; P, proximal; PM, proximal to middle). 1 Figure 2: Morphology of long-bone segments: St, simple-transverse; Ss, simple-spiral; I, intermediate; C, complex. 2