Podiatry Classification Systems

Front 1

Gustillo & Anderson Classification

Back 1

Open Fractures classification

Type 1:Wound <1cm long, little ST damage, no sign of crush, simple/transverse/oblique fx w/ little comminution

Type II – Wound >1cm long, minor ST damage, slight/moderate crush injury, moderate comminution

Type III – Extensive ST injury, high degree of comminution

IIIa – ST coverage of bone is adequate, trauma high-energy
IIIb – extensive ST damage requiring free-flap for coverage, assoc w/ periosteal stripping and ST contamination
IIIc – any open fx w/ arterial injury requiring immediate repair 

Front 2

ECKERT & DAVIS Classification

Back 2

Superior Peroneal Retinaculum rupture 

Grade I – The retinaculum is stripped away from the fibula, resulting in dislocation of the tendons.

Grade II – The fibrocartilaginous ridge and the SPR is avulsed from the posterior aspect of the fibula.

Grade III – a thin fragment of bone w/ cartilage is avulsed from deep surface of peroneal retinaculum & deep fascia

Grade IV (Oden) – a mid-substance tear 

Front 3

ESSEX-LOPRESTI Classification

Back 3

Calcaneal Fractures:

Tongue Type – Primary fx line (Gissans straight down) + 2ndry line that extends straight posterior

Joint Type –  (Intra-articular) Primary fx line + 2ndry line to behind posterior facet

 

Front 4

SANDER’S CLASSIFICATION 

Back 4

CT scan at widest width of calcaneus

Type I (A, B, and C) –  nondisplaced articular fx. 

Type II (A, B, and C) – two part fx of posterior facet. 

Type III (AB, AC, and BC) – three part fx w/ central depressed segment.

Type IV – comminuted fx of posterior facet. 

Front 5

ROWE CLASSIFICATION 

Back 5

Calcaneal fractures

Type Ia – plantar (medial) calcaneal tuberosity fx

Type Ib – sustentaculum tali

Type Ic – anterior process fx

Type IIa – “beak fracture,” no achilles involved

Type IIb – avulsion fx of the tendo Achilles 

Type IIIa – extraarticular calcaneal body fx

Type IIIb – same as IIIa, but comminuted. 

Type IVa&b – same as type III, but w/ STJ involvement. 

Type Va – intraarticular STJ fx w/ comminution and depression of the articular segment.
Type Vb – intraarticular fx of the calcaneo-cuboid joint. 

Front 6

HARDCASTLE CLASSIFICATION 

Back 6

LISFRANC’S FRACTURES  

Type A – Total incongruity...either homolateral or homomedial 

Type B – Partial incongruity; not all metatarsals displaced in the same direction.

Type C – Divergent; 1st metatarsal is medially dislocated, 2-5are either partially or completely laterally dislocated. 

Front 7

BERNDT-HARDY CLASSIFICATION 

Back 7

TALAR DOME LESIONS  

Stage I – small area of compression in subchondral bone.

Stage II – partially detached osteochondral fragment.
Stage III – completely detached fragment, in crater.

Stage IV – complete fx, out of crater. Poor prognosis 

Front 8

DIAL a PIMP 

Back 8

denotes the location of talar dome lesions – dorsiflexion internal rotation = anterior lateral lesion,

plantarflexion inversion = medial posterior lesion.
Medial Lesions: (PIMP, 56%) Deep, cup shaped, less likely to displace.

Lateral Lesions: (DIAL, 44% ) Thin, wafer shaped, easily displaced. 

Front 9

JOHNSON AND STROM Classification

Back 9

PTTD (each stage includes previous)

Stage I – Medial pain, tenosynovitis, mild weakness on heel-raise test

Stage II – Medial/lateral pain, tendon elongation, flexible pes planus, too many toes sign
Stage III –  tendon degeneration, fixed pes planus, no inversion on heel raise, STJ arthritis 

 Stage IV –  Valgus talus, Ankle arthritis 

Front 10

LAUGE-HANSEN CLASSIFICATION 

Back 10

ANKLE FRACTURES  

SAD (Weber A)

SER (Weber B posterior spike)

PER (Weber C)

PABD (Weber B superior spike)

Front 11

LAUGE-HANSEN CLASSIFICATION 

Supination – Adduction 

Back 11

SAD

1. Transverse fx of lateral malleolus (Weber type A)

2. Vertical fx of medial malleolus (Muller type D)

Front 12

LAUGE-HANSEN CLASSIFICATION 

Supination – External Rotation 

Back 12

SER

1. Rupture of anterior syndesmosis or fx of anterior  (Tillaux-chaput fx[ant-inf-lat tibia], wagstaff fx [ant-inf-med fibia])

2. Ant-inf oblique fx of lateral maleolus with posterior spike (weber B)

3. Rupture of posterior syndesmosis or fx of posterior malleolus of tibia

4. rupture of deltoid ligament or transverse fx of medial malleolus (Muller type A or B)

Front 13

LAUGE-HANSEN CLASSIFICATION 

Pronation – External Rotation 

Back 13

PER

1. Medial malleolus transverse avulsive fx (muller A or B) or rupture of deltoid

2. Rupture of anterior syndesmosis or fx of anterior  (Tillaux-chaput fx[ant-inf-lat tibia], wagstaff fx [ant-inf-med fibia])

3. Obliaque spiral fx of superior fibula (Maison nueve; Weber type C)

4. Rupture of posterior syndesmosis or fx of posterior malleolus of tibia

Front 14

LAUGE-HANSEN CLASSIFICATION 

Pronation – Abduction 

Back 14

PAB

1. Rupture of deltoid ligament or transverse fx of medial malleolus (Muller type A or B)

2. Rupture of anterior syndesmosis or fx of anterior  (Tillaux-chaput fx[ant-inf-lat tibia], wagstaff fx [ant-inf-med fibia])

3. Spiral oblique fx of fibula at level of ankle with superior spike (Weber type B)

Front 15

HAWKIN’S CLASSIFICATION 

Back 15

TALAR NECK FRACTURES 

 

Type I – minimal displacement, 7-15% chance of AVN
Type II – STJ subluxation, 35-50% chance of AVN
Type III – ankle dislocation, 85% chance of AVN
Type IV – STJ/ankle/TNJ dislocation, 100% chance of AVN

Hawkin’s Sign – subchondral lucency of the body of the talus following fx; appears 6-8 weeks post fx; = revascularization 

Front 16

STEWART CLASSIFICATION

Back 16

5TH METATARSAL BASE FRACTURES 

Type I – “Jones Fracture,” transverse fx of diaphyseal /metaphyseal junction. Healing potential is poor.

Type II – Intraarticular avulsion fx

Type III – Extraarticular avulsion fx
Type IV – Intraarticular comminuted fx

Type V – (peds) Extraarticular fx through epiphysis 

Front 17

EICHENHOLTZ, SHIBATA, YU Classification

Back 17

CHARCOT FOOT  

Stage 0 – swelling, warmth, w/ joint instability

Stage I – destructive phase w/ joint laxity, subluxation, and osteochondral fragmentation
Stage II – coalescence; absorption of debris and fusion of larger fragments to adjacent bone

Stage III – remodeling; revascularization and remodeling of bone and fragments 

Front 18

Frykberg classification Charcot

Back 18

CHARCOT ANATOMIC CLASSIFICATION 

Zone 1 – Distal and proximal interphalangeal joints,metatarsophalangeal joints

Zone 2 – Tarsometatarsal joints (Lisfrancs)
Zone 3 – Naviculo-cunieform joints, talo-navicular joint, calcaneocuboid joint
Zone 4 – Ankle joint, subtalar joint

Zone 5 – Calcaneus

Front 19

WAGNER CLASSIFICATION

Back 19

FOOT ULCERATION 

Grade 0 – Skin is intact, no open lesions.

Grade 1 – Skin only lesion

Grade 2 – Deeper lesion involving tendon, muscle, or bone

Grade 3 – Grade 2 w/ infection (abscess, osteomyelitis)

Grade 4 – Partial gangrene in the forefoot

Grade 5 – Entire foot is gangrenous, no procedures possible 

Front 20

UTSA CLASSIFICATION

Back 20

FOOT ULCERATION 

Grade 0 – pre or post ulcerative lesion, epithelialized

Grade 1 – superficial wound, w/ out tendon, capsule or bone

Grade 2 – wound penetrating to capsule, tendon, or bone

Grade 3 – wound penetrating to bone or joint
Type A – Clean, vascular wound

Type B – Infected, vascular wound

Type C – Clean, ischemic wound

Type D – Infected, ischemic wound

Front 21

FREIBERG AVN Classification

Back 21

AVN OF THE 2ND METATARSAL 

 

Type I – no DJD, articular cartilage intact
Type II – periarticular spurs, articular cartilage intact 

Type III – severe DJD, loss of articular cartilage

Type IV – epiphyseal dysplasia, multiple head involvement

 

Front 22

IDSA Classification

Back 22

Classification for Diabetic foot infection

Uninfected: No SOI

Mild: Local erythema < 2cm

Moderate: erythema > 2cm or deep tissue involvement

Severe: systemic evidence of infection

Front 23

CLARK & BRESLOW Classifications

Back 23

MALIGNANT MELANOMA  

CLARK (layer)

Level 1 – epidermis to dermal/epidermal junction

Level 2 – papillary dermis

Level 3 – to reticular dermis

Level 4 – reticular dermis

Level 5 – subcutaneous fat

BRESLOW (depth)

Level 1 - <0.75mm

Level 2 – 0.76-1.5mm

Level 3 – 1.51-2.25mm

Level 4 – 2.26-3.0mm

Level 5 - >3mm

Front 24

RUEDI & ALLGOWER CLASSIFICATION 

Back 24

PILON FRACTURES 

Type 1- Mild to moderate displacement & no comminution,w/o major disruption of ankle joint

Type 2- Moderate displacement & no comminution w/ significant dislocation of ankle joint
Type 3- Explosion fx, severe comminution & displacement 

Front 25

SALTER-HARRIS CLASSIFICATION 

Back 25

EPIPHYSEAL FRACTURES 

Type I – shearing force, separation of epiphysis from metaphysis 

Type II - fx line extends through physis and exits metaphysis. 

Type III – fx line extends through physis and exits epiphysis 

Type IV – intraarticular fx through epiphysis, physis, and metaphysis.

Type V – compression fx

Front 26

SNEPPEN Classification

Back 26

FRACTURES OF THE TALAR BODY 

Group I – Talar Dome Fracture/OCD (use Berndt-Hardy)

Group II – Shear Fracture – 50% AVN; Coronal; Sagittal; Horizontal 

Group III – Posterior Tubercle Fracture (Shepherd’s Fx)

Group IV – Lateral Process Fracture (Fjeldborg)
Group V – Crush injury – highly comminuted 

Front 27

MANOLI AND WEBER Classification

Back 27

COMPARTMENTS OF THE FOOT  

CALCANEUS: quadratus plantae, posterior tibial

artery, vein, and nerve, lateral plantar artery, vein, nerve, medial plantar artery, vein, nerve, communicates with deep leg 

ADDUCTOR/INTEROSSEUS : interossei; adductor hallucis

MEDIAL: flexor hallucis, abductor hallucis 

LATERAL: abductor digiti quinti, flexor digiti minimi

SUPERFICIAL: flexor digitorum brevis, lumbricals (4), flexor digitorum longus tendons, medial plantar nerve 

 

Front 28

Critial Angle of Gissane:  

Back 28

- The Angle of Gissane, or "Critical Angle", is the angle formed by the downward and upward slopes of the superior calcaneal surface.

- Normal is 120-140 and a fractured calcaneus will increase this angle

Front 29

Bohler’s Angle 

Back 29

- flat line over anterosuperior vs flat line over posterpsuperior

- normal is 18-40 and it decreases in calcaneal fxs 

Front 30

Rosenthal classification

Back 30

Nail injury classification

Zone 1 – distal to distal phalanx

Zone 2 – distal to lunula

Zone 3 – proximal to lunula (Amputation of distal phalanx) 

Front 31

JAHS Classification

Back 31

1ST MPJ DISLOCATIONS  

Type I – Hallux/sesamoid dislocation, no disruption of sesamoid apparatus, irreducible to closed reduction. 

Type IIa – closed reducible, disrupted intersesamoidal ligament
Type IIb – closed reducible, transverse fx of sesamoids

Type IIc – open reduction, both IIa and IIb.