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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.

41A1 Extraarticular, avulsion fracture

41A1.1 Of the capsular attachments

41A1.2 Of the tibial tubercle

41A1.3 Of tibial spine (cruciate attachment)

41A2 Extraarticular, simple fracture

41A2.1 Spiral fracture

41A2.2 Oblique fracture

41A2.3 Transverse fracture

41A3 Extraarticular, wedge or multifragmentary fracture

41A3.1* Intact wedge fracture

*Qualifications:
f – Lateral
h - Medial

41A3.2* Fragmentary wedge fracture

*Qualifications:
f – Lateral
h - Medial

41A3.3 Multifragmentary fracture

41B1 Partial articular, split fracture

41B1.1 Lateral plateau fracture

41B1.2 Medial plateau fracture

41B1.3* Oblique, involving the tibial spines

and 1 of the tibial plateaus

*Qualifications:
f – Lateral
h - Medial

41B2 Partial articular, depression fracture

41B2.1 Lateral plateau fracture

41B2.2 Medial plateau fracture

41B3 Partial articular, split-depression fracture

41B3.1* Lateral plateau fracture

*Qualifications:
t - Anterolateral (AL)
u - Posterolateral (PL)
x - Central

41B3.2* Medial plateau fracture

*Qualifications:
v - Anteromedial (AM)
w - Posteromedial (PM)
x - Central

41B3.3* Involving the tibial spines and 1 of the tibial plateaus

*Qualifications:
f - Lateral
h - Medial

41C1 Complete, simple articular, simple metaphyseal fracture

41C1.1 Without intercondylar eminence fracture

41C1.2 With intercondylar eminence fracture

41C2 Complete, simple articular, wedge or multifragmentary metaphyseal fracture

41C2.1* Intact wedge fracture

*Qualifications:
f - Lateral
h - Medial

41C2.2* Fragmentary wedge fracture

*Qualifications:
f - Lateral
h - Medial

41C2.3 Multifragmentary metaphyseal fracture

41C3 Complete, fragmentary or multifragmentary metaphyseal fracture

41C3.1* Fragmentary lateral plateau fracture

*Qualifications:
d - Simple metaphysis
e - Multifragmentary metaphysis
s - Metadiaphyseal extension
t - Anterolateral (AL)
u - Posterolateral (PL)
v - Anteromedial (AM)
w - Posteromedial (PM)
x - Central

41C3.2* Fragmentary medial plateau fracture

*Qualifications:
d - Simple metaphysis
e - Multifragmentary metaphysis
s - Metadiaphyseal extension
t - Anterolateral (AL)
u - Posterolateral (PL)
v - Anteromedial (AM)
w - Posteromedial (PM)
x - Central

41C3.3* Multifragmentary medial and lateral plateau fracture

*Qualifications:
d - Simple metaphysis
e - Multifragmentary metaphysis
s - Metadiaphyseal extension
t - Anterolateral (AL)
u - Posterolateral (PL)
v - Anteromedial (AM)
w - Posteromedial (PM)
x - Central

Executive Editor: Ernst Raaymakers, Joseph Schatzker, Rick Buckley

Authors: Matthias Hansen, Rodrigo Pesantez

Additional credits

Proximal tibia

Appendix

Note

Undisplaced fractures with retained stability of the joint do not require surgical treatment. They require protection in a fracture brace to prevent displacement.

The exceptions to this rule are fractures involving the medial tibial plateau B3.2 and B3.3 because in these, even if undisplaced, there is a high risk of secondary displacement. A further exception would be complications requiring surgical treatment.

Surgery is required if the joint is unstable, if the articular surface is fractured and displaced, if there is axial deformity, and if the fracture involves the medial condyle.

Surgery is required if there is joint instability, articular surface incongruity, and axial deformity.

Shortcuts

Evidence summary

Decision support

Additional material

Further reading

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v2.0 2010-05-15