Johner and Wruhs developed a scheme for classifying fractures of the tibial shaft. This recognizes 3 main groups, each with 3 subtypes, giving 9 patterns.
Basic patterns:
(A) simple fractures
(B) fractures with butterfly or wedge pattern
(C) segmental or comminuted fractures
|
Basic Pattern |
Subtypes |
Group |
|
simple |
simple spiral fracture |
A1 |
|
|
oblique |
A2 |
|
|
transverse |
A3 |
|
butterfly or wedge pattern |
butterfly by torsion |
B1 |
|
|
single butterfly |
B2 |
|
|
compound butterfly |
B3 |
|
segmental or comminuted |
comminuted by torsion |
C1 |
|
|
segmental fracture (proximal and distal fractures with segment between) |
C2 |
|
|
crush |
C3 |
|
Group |
Possible Scenarios |
Mechanism |
|
A1 |
slipping or skiing |
torsion |
|
A2 |
crash on motorcycle or in car |
uneven bending |
|
A3 |
crash on motorcycle or in car |
pure bending |
|
B1 |
skiing |
torsion and bending |
|
B2 |
low speed motor accident |
bending and compression |
|
B3 |
high speed motor accident |
bending and compression |
|
C1 |
high speed skiing |
high speed torsion |
|
C2 |
car bumper impact |
4-point bending |
|
C3 |
war, crush injury, high speed motor accident, industrial |
crush injury |
Specialty: Surgery, orthopedic, Emergency Medicine, Critical Care, Surgery, general
