All fractures are either simple or multifragmentary.
simple: A term used to characterize a single circumferential disruption of a diaphysis or metaphysis or a single disruption of an articular surface. Simple fractures of the diaphysis or metaphysis are spiral, oblique or transverse.
multifragmentary: A term used to characterize any fracture with one or more completely separated intermediate fragment(s). In the diaphyseal segment and in the metaphysis, it includes the wedge and the complex fractures. The terms wedge and complex are used only for diaphyseal or metaphyseal fractures.
wedge: A fracture with one or more intermediate fragment(s) in which, after reduction, there is some contact between the main fragments. The spiral or bending wedge may be intact or fragmented.
complex: A fracture with one or more i ntermediate fragment(s) in which, after reduction, there is no contact between the main proximal and distal fragments. The complex fractures are spiral, segmented or irregular.
The term comminuted is imprecise and should not be used.
impacted: A stable and usually simple fracture of the metaphysis or epiphysis in which the fragments are driven one into the other.
Specific Terms for the Proximal and Distal Segments:
Fractures of the proximal and distal segments are eitherextra-articular or articular.
extra-articular fractures: These do not involve the articular surface, although they may be intra-capsular. They include apophyseal and metaphyseal fractures. Articular fractures involve the articular surface. They are subdivided into partial and complete.
partial articular fractures: The fractures involve only part of the articular surface, while the rest of that surface remains attached to the diaphysis. Types of partial articular fractures:
pure split: A fracture, resulting from a shearing force, in which the direction of the split is usually longitudinal.
pure depression: An articular fracture in which there is pure depression of the articular surface without a split. The depression may be central or peripheral.
split-depression: A combination of a split and a depression, in which the joint fragments are usually separated.
multifragmentary depression: A fracture in which part of the joint is depressed and the fragments are completely separated. complete articular fractures: The articular surface is disrupted and completely separated from the diaphysis. The severity of these fractures depends on whether its articular and metaphysealcomponents are simple or multifragmentary.