Trafton described a classification system for fractures of the tibial shaft. It is based on classifications of Ellis and Edwards and incorporates soft tissue wound grading.
Parameters:
(1) displacement
(2) comminution
(3) wound
(4) available energy involved (by history)
(5) mechanism (fracture pattern)
|
Parameter |
Finding |
Grade |
|
displacement |
0% - 50% of diameter |
minor |
|
|
51 – 100% |
moderate |
|
|
tibiofibular diastasis |
major |
|
comminution |
none to minimal |
minor |
|
|
0 or 1 butterfly fragments |
moderate |
|
|
>= 2 free fragments or segmental |
major |
|
wound |
open grade I, closed grade 0 |
minor |
|
|
open grade II, closed grade I |
moderate |
|
|
open grade III-IV; closed grade II-III |
major |
|
energy involved |
low |
minor |
|
|
moderate |
moderate |
|
|
high; crushing |
major |
|
mechanism |
spiral |
minor |
|
|
oblique/transverse |
moderate |
|
|
transverse/fragmented |
major |
severity of fracture =
= MAX(grade for any of the 5 parameters)
Specialty: Surgery, orthopedic, Emergency Medicine, Critical Care, Surgery, general
