CHAPTER 7 • ORTHOPEDIC SPORTS MEDICINE TERMINOLOGY 33in bowing of the affected bone, with the affected
cortex always occurring on the convex surface- Jones fracture:Fracture of the base of the small
metatarsal occurring at the metaphyseal–diaphyseal
junction. The significance is that this is a vascular
watershed area resulting in an increased propensity to
nonunion requiring a short leg cast and nonweight
bearing. - Lis-Franc’s fracture/dislocation:Occurring at the
tarsometatarsal joint of the foot. There are two types:
Homolateral (all rays dislocate laterally) and diver-
gent (lesser rays are dislocated laterally). - Maissoneuve fracture:Fracture of the proximal one-
third of the fibula associated with rupture of the
tibia–fibula syndesmosis and fracture of the medial
malleolus or rupture of the deltoid ligament - Mallet finger (baseball finger):Flexion deformity of
the distal phalanx resulting from a separation of the
common extensor tendon at its insertion at the dorsal
base of the distal phalanx with or without an avulsion
fracture - March fracture:Stress or fatigue fracture usually
referring to the metatarsals - Monteggia’s fracture:Fracture of the proximal third
of the ulna with anterior dislocation of the radial
head. - Nightstick fracture:Fracture of the ulnar shaft
- Piedmont fracture:Isolated, closed fracture of the
radius at the junction of the middle or distal-thirds - Rolando’s fracture:Y-shaped intra-articular fracture
at the base of the thumb metacarpal - Segond’s fracture (lateral capsular sign):Avulsion
fracture of the lateral capsule off the lateral tibial
plateau associated with an ACL injury. - Torus fracture (“buckle” fracture):Incomplete frac-
ture with buckling of one cortex predominantly in
skeletally immature patients. It usually occurs with a
fall on an outstretched hand and is a stable fracture.
CLASSIFICATION SYSTEMS
ACROMIOCLAVICULAR JOINT INJURIES
- Type 1:Acromioclavicular(AC) ligament sprain
- Type 2:Partial tear of the AC ligament; sprain of cora-
coclavicular(CC) ligaments - Type 3:AC and CC ligaments disrupted with superior
displacement of the clavicle <100% of the width of
the clavicle - Type 4:AC and CC ligaments disrupted with clavicle
displaced into or through trapezius - Type 5:As in type 3 except that clavicle is displaced
superiorly 100–300%.- Type 6:AC and CC ligaments disrupted with clavicle
displaced inferiorly
- Type 6:AC and CC ligaments disrupted with clavicle
ACROMION MORPHOLOGY- Bigliani described the morphology of the acromion. It
is felt that increasing curvature is associated with
higher risk for rotator cuff pathology and impinge-
ment. The classification system is based on morphol-
ogy of the acromion as seen on the supraspinatus
outlet(SSO) view radiograph. The increased curva-
ture is most often associated with arthrosis of the
acromion. - Type 1:Flat acromion
- Type 2:Curved acromion
- Type 3:Hooked acromion
ARTICULAR CARTILAGE LESIONS- Outerbridge published his classification system for
chondromalacia patellae. Today it is used to classify
chondrosis thoughout the knee and other joints, as
well. This classification is often used incorrectly, and
a new classification system is needed. Until then, the
author recommends the lesions be described on the
basis of anatomic location, dimension of lesions, and
depth of penetration in order to avoid any misunder-
standings in communication.
MODIFIED OUTERBRIDGE CLASSIFICATION- Grade I:Cartilage softening and swelling
- Grade II:Fragmentation and fissuring <1 cm in dia-
meter - Grade III:Fragmentation and fissuring >1cm in dia-
meter - Grade IV: Erosion of cartilage to bone (i.e., full
thickness damage)
AMERICAN MEDICAL ASSOCIATION LIGAMENT
INJURY CLASSIFICATION- Grade I:Minor tearing without increase in transla-
tion of affected joint (with laxity testing on PE) - Grade II:Partial tear with mild-moderate increased
translation - Grade III:Complete tear with marked increase in
translation