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Revised AO/OTA classification (Jan 2018)


A revision of the AO/OTA Fracture and Dislocation Classification was published in the January 2018 issue of the Journal of Orthopaedic Trauma (Compendium and support material). This module is organized according to the 2007 version. Please read through its revised classification (below) before returning to the AO Surgery Reference.

43A1 Extraarticular, simple fracture

43A1.1 Spiral fracture

43A1.2 Oblique fracture

43A1.3 Transverse fracture

43A2 Extraarticular, wedge fracture

43A2.1 Posterolateral impaction fracture

43A2.2 Anteromedial wedge fracture

43A2.3 Fracture extending into diaphysis

43A3 Extraarticular, multifragmentary fracture

43A3.1 With 3 intermediate fragments

43A3.2 With more than 3 intermediate fragments

43A3.3 Extending into diaphysis

43B1 Partial articular, split fracture

43B1.1* Frontal/coronal fracture

o - Anterior
y - Posterior Volkmann

43B1.2* Sagittal fracture

f - Lateral
z - Medial articular surface including medial malleolus

43B1.3 Fragmentary metaphyseal fracture

43B2 Partial articular, split depression fracture

43B2.1* Frontal/coronal fracture

o - Anterior
y - Posterior Volkmann

43B2.2* Sagittal fracture

f - Lateral
h - Medial

43B2.3 Central fragment fracture

43B3 Partial articular, depression fracture

43B3.1* Frontal/coronal fracture

o - Anterior
y - Posterior Volkmann

43B3.2* Sagittal fracture

f - Lateral
h - Medial

43B3.3 Fragmentary metaphyseal fracture

43C1 Complete, simple articular, simple metaphyseal fracture

43C1.1* Without impaction

q - Frontal/coronal plane
r - Sagittal plane

43C1.2 With epiphyseal depression

43C1.3 Extending into diaphysis

43C2 Complete, simple articular, multifragmentary metaphyseal fracture

43C2.1* With asymmetric impaction

q - Frontal/coronal plane
r - Sagittal plane

43C2.2 Without asymmetric impaction

43C2.3 Extending into diaphysis

43C3 Complete, multifragmentary articular and metaphyseal fracture

43C3.1 Epiphyseal fracture


43C3.2 Epiphyseal-metaphyseal fracture

43C3.3 Epiphyseal-metaphyseal-diaphyseal fracture

Executive Editor: Peter Trafton

Authors: Martin Hessmann, Sean Nork, Christoph Sommer, Bruce Twaddle

Additional credits

Distal tibia



Distal tibia fractures are primarily located within a square based on the width of the distal tibia.

Many fractures of the distal tibia have severe associated soft-tissue compromise.

Assess the soft-tissue condition, sensation and motor function in the foot. Watch for signs of a compartment syndrome, which may develop some time after injury.

Grossly displaced / dislocated fractures
must be reduced immediately and temporarily stabilized, preferably by a joint-bridging external fixator.


Evidence summary

Decision support

Additional material

Further reading

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v1.0 2008-12-03