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Revised AO/OTA classification (Jan 2018)

Introduction

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.

44A1 Infrasyndesmotic, isolated fibula injury

44A1.1 Rupture of the lateral collateral ligament

44A1.2 Avulsion fracture of the tip of the lateral malleolus

44A1.3 Transverse fracture of the lateral malleolus

44A2 Infrasyndesmotic fibula injury with a medial malleolar fracture

44A2.1 Rupture of the lateral collateral ligament

44A2.2 Avulsion fracture of the tip of the lateral malleolus

44A2.3 Transverse fracture of the lateral malleolus

44A3 Infrasyndesmotic fibular injury with a posteromedial fracture

44A3.1 Rupture of the lateral collateral ligament with a posteromedial fracture

44A3.2 Avulsion fracture of the tip of the lateral malleolus with a posteromedial fracture

44A3.3 Transverse fracture of the lateral malleolus with a posteromedial fracture

44B1 Transsyndesmotic isolated fibula fracture

44B1.1* Simple fibula fracture

*Qualifications:
n - Tillaux-Chaput tubercle fracture
o - Wagstaffe-Le Fort avulsion fracture
u - Syndesmosis unstable

44B1.2* With a rupture of the anterior syndesmosis

*Qualifications:
n - Tillaux-Chaput tubercle fracture
o - Wagstaffe-Le Fort avulsion fracture
u - Syndesmosis unstable

44B1.3* Wedge or multifragmentary fibula fracture

*Qualifications:
n - Tillaux-Chaput tubercle fracture
o - Wagstaffe-Le Fort avulsion fracture
u - Syndesmosis unstable

44B2 Transsyndesmotic fibula fracture with a medial injury

44B2.1* With a rupture of the deltoid ligament and anterior syndesmosis

*Qualifications:
n - Tillaux-Chaput tubercle fracture
o - Wagstaffe-Le Fort avulsion fracture
u - Syndesmosis unstable

44B2.2* With a medial malleolus fracture and a rupture of the anterior syndesmosis

*Qualifications:
n - Tillaux-Chaput tubercle fracture
o - Wagstaffe-Le Fort avulsion fracture
u - Syndesmosis unstable

44B2.3* Wedge or multifragmentary fibula fracture with medial injury

*Qualifications:
r - Rupture of deltoid ligament
s - Fracture of medial malleolus
u - Syndesmosis unstable

44B3 Transsyndesmotic fibula fracture with a medial injury and fracture of the posterolateral rim (Volkmann’s fragment)

44B3.1* Simple, with a deltoid ligament rupture

*Qualifications:
n - Tillaux-Chaput tubercle fracture
o - Wagstaffe-Le Fort avulsion fracture
u - Syndesmosis unstable

44B3.2* Simple medial malleolus fracture

*Qualifications:
n - Tillaux-Chaput tubercle fracture
o - Wagstaffe-Le Fort avulsion fracture
u - Syndesmosis unstable

44B3.3* Wedge or multifragmentary fibular fracture with a fracture of the medial malleolus

*Qualifications:
n - Tillaux-Chaput tubercle fracture
o - Wagstaffe-Le Fort avulsion fracture
u - Syndesmosis unstable

44C1 Suprasyndesmotic, simple diaphyseal fibula fracture

44C1.1* With a rupture of the deltoid ligament

*Qualifications:
t - Syndesmosis stable
u - Syndesmosis unstable

44C1.2* With a fracture of the medial malleolus

*Qualifications:
t - Syndesmosis stable
u - Syndesmosis unstable

44C1.3* With a medial and a posterior malleolus fracture

*Qualifications:
t - Syndesmosis stable
u - Syndesmosis unstable

44C2 Suprasyndesmotic, wedge or multifragmentary diaphyseal fibula fracture

44C2.1* With a rupture of the deltoid ligament

*Qualifications:
t - Syndesmosis stable
u - Syndesmosis unstable

44C2.2* With a fracture of the medial malleolus

*Qualifications:
t - Syndesmosis stable
u - Syndesmosis unstable

44C2.3* With a fracture of the medial malleolus and posterior malleolus

*Qualifications:
t - Syndesmosis stable
u - Syndesmosis unstable

44C3 Suprasyndesmotic, proximal fibula injury

44C3.1* With a medial side injury

*Qualifications:
p - Fibula neck fracture
q - Proximal tibio-fibular joint dislocation
r - Rupture of deltoid ligament
s - Fracture of medial malleolus

44C3.2* With shortening and a medial side injury

*Qualifications:
p - Fibula neck fracture
q - Proximal tibio-fibular joint dislocation
r - Rupture of deltoid ligament
s - Fracture of medial malleolus

44C3.3* With a medial side injury and a posterior malleolus fracture

*Qualifications:
p - Fibula neck fracture
q - Proximal tibio-fibular joint dislocation
r - Rupture of deltoid ligament
s - Fracture of medial malleolus

Executive Editor: Steve Krikler

Authors: Paulo Barbosa, Felix Bonnaire, Kodi Kojima

Additional credits

Malleoli

Appendix

Note

Complete radiological evaluation (AP, lateral and AP with internal rotation) is crucial for correct classification and decision making.

Shortcuts

Decision support

Additional material

Further reading

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v1.0 2006-12-04