Fracture and dislocation classification compendium for children: the AO pediatric comprehensive classification of long bone fractures (PCCF)

Abstract

The AO Pediatric Expert Group and the AO Pediatric Classification Group, in cooperation with the AO Investigation and Documentation Group introduce and present the first comprehensive classification of pediatric long bone fractures. The anatomy is related to the 4 long bones and their 3 segments defined as proximal (1), shaft (2) and distal (3). It is further described by the fracture subsegment recorded as epiphyseal (E), metaphyseal (M) and diaphyseal (D), whereby proximal and distal fractures are classified as E or M and shaft fractures are always D. The distinction between metaphyseal and diaphyseal fractures is achieved by localizing the center of fracture lines with regard to a square drawn over the respective growth plates. The morphology of the fracture is documented by a subsegment-specific child pattern code, a severity code as well as an additional code for displacement of specific fractures such as supracondylar fractures and radial heads. The classification process requires trained observers to read standard radiographic images.