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Duke Orthopaedics
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Wheeless' Textbook of Orthopaedics

Winquist Classification of Femoral Shaft Frx



 - Type I:  
      - comminution is minimal or there is no comminution at frx site

 - Type II:
      - comminution involves a fragment larger than that in type I but has at least 50% of the circumference of the cortices of two major frx fragments intact;
      - broad cortical contact following frx reduction & nailing prevents shortening & malrotation, simple IM nailing suffices for most type II frx;

 - Type III:
      - injuries, between 50 and 100% of the circumference of two major frx fragments is comminuted;
      - such large butterfly fragments compromises frx fixation since broad cortical abutment of major frx fragments is impossible;
      - simple intramedullary nails are insufficient for type III frx and must be supplemented with interlocking screws, cerclage wires, or post operative traction or bracing;

 - Type IV:
      - all cortical contact is lost in type IV injuries;
      - cortex is circumferentially comminuted over a segment of bone;
      - even w/ intramedullary nailing, there is no contact between proximal and distal fragments; all inherent stability of fractue is lost



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Thursday, September 13, 2012 2:58 pm