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Search verified OrthoNotes topics and open their connected cases, MCQs, resources, and atlas entries.

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122 visible knowledge nodes in trauma

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Danis–Weber Classification — Ankle (Fibula Level)

A: infra-syndesmotic; B: at syndesmosis; C: supra-syndesmotic (Maisonneuve possible). Instability rises from A→C; C requires ORIF with syndesmotic fixation.

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Delbet–Colonna Classification — Paediatric Femoral Neck Fractures

Type I: Transepiphyseal (with/without dislocation) — highest AVN risk. Type II: Transcervical (through the neck). Type III: Cervicotrochanteric (basicervical). Type IV: Intertrochanteric. AVN risk decreases from I → IV; urgent reduction and stable fixation reduce complications.

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Denis Classification — Sacral Fractures (Zones)

Zone 1: lateral to foramina (alar) — low neuro risk. Zone 2: through foramina — higher L5/S1 root risk. Zone 3: medial to foramina (central canal) — highest cauda equina risk.

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Denis Three-Column — Thoracolumbar Injuries

Compression: anterior column only — usually stable. Burst: anterior + middle columns — unstable, canal compromise risk. Flexion-distraction (Chance): posterior tension failure — unstable. Fracture-dislocation: all three columns — highly unstable, neuro injury common.

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Distal Femur Fractures

AO 33 classification. Locking plate vs retrograde nail. Principles: joint first, then shaft. Complications: nonunion, malalignment, stiffness.

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Distal Radius — Colles/Smith/Barton

Colles: extra-articular, dorsal tilt; Smith: extra-articular, volar tilt; Barton: intra-articular rim fracture. Clinical deformities: dinner-fork (Colles), garden-spade (Smith). Stability factors: dorsal comminution, >20° angulation, >5 mm shortening, intra-articular involvement. Treatment: closed reduction/cast vs volar plate fixation. Complications: malunion, CRPS, post-traumatic arthritis.

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Elbow Dislocations — Terrible Triad

Terrible triad = posterior elbow dislocation + radial head fracture + coronoid fracture. Highly unstable pattern, requires surgical fixation of all components. Goal: concentric reduction + early mobilization in stable arc. Complications: stiffness, recurrent instability, arthritis, heterotopic ossification.

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Evans/Jensen — Intertrochanteric Femur

Stable: intact posteromedial buttress; Unstable: posteromedial comminution, reverse obliquity, subtrochanteric extension. Stable → DHS; Unstable → cephalomedullary nail/fixed-angle device.

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External Fixators — Concepts

Types: uniplanar, biplanar, circular. Biomechanics: stiffness ↑ with larger pins, more pins, wider spread, closer frame. Indications: open fractures, polytrauma, infected nonunion, limb lengthening. Advantages: minimal soft tissue stripping, adjustability. Disadvantages: pin site infection, stiffness, bulky frame.

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Fat Embolism Syndrome

Classically 24–72 h after long‑bone/pelvic fractures or IM reaming; triad: hypoxemia, neurological signs, petechiae. Diagnosis is clinical; supported by Gurd’s criteria (1 major + 4 minor) or Schonfeld score (>5). ABG hypoxemia, CXR fluffy infiltrates; brain MRI 'starfield' pattern on DWI. Prevention: early stabilization of long bone fractures; careful reaming/venting. Management: supportive (oxygen/PEEP, fluids), avoid overload; steroids controversial.

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Femoral Neck Fracture — Garden/Pauwels

Garden I–II = non-displaced, III–IV = displaced. Pauwels I 50° vertical shear. Young = urgent reduction + fixation (CS/DHS). Elderly = arthroplasty if displaced. Complications: AVN, nonunion.

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Femoroacetabular Impingement (FAI) — Cam, Pincer & Mixed

Comprehensive guide to femoroacetabular impingement (FAI) covering cam, pincer, and mixed morphologies, alpha angle measurement, Tönnis grading, clinical assessment, conservative and surgical management including hip arthroscopy.

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Floating Joints — Floating Knee, Floating Elbow & Floating Shoulder

Comprehensive guide to floating joint injuries covering floating knee (Fraser classification, ipsilateral femur and tibia fractures), floating elbow (ipsilateral humerus and forearm fractures in children), and floating shoulder (ipsilateral clavicle and scapular neck fractures, superior shoulder suspensory complex), with management principles, surgical indications, and complications for each pattern.

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Frykman Classification — Distal Radius

Types I–VIII: extra- vs intra-articular, DRUJ involvement, and ulnar styloid fracture. Intra-articular (III–VIII) have higher arthritis risk; often require ORIF.

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Galeazzi Injury

Radial shaft fracture with disruption of the distal radioulnar joint (DRUJ). Occurs in middle to distal third radius fracture. Requires ORIF of radius and stabilization of DRUJ. Called 'fracture of necessity' because surgery is mandatory in adults. Complications: DRUJ instability, chronic pain, stiffness.

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Galeazzi Injury — Distal Radius + DRUJ Disruption

Distal radial shaft fracture with distal radioulnar joint (DRUJ) disruption. Unstable pattern: ORIF radius and stabilize DRUJ.

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Garden Classification — Femoral Neck (Intracapsular)

I: incomplete/valgus impacted; II: complete, nondisplaced. III: complete, partially displaced (varus); IV: complete, fully displaced. I–II stable → fixation; III–IV unstable → arthroplasty in elderly (high AVN/nonunion).

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Gartland Classification — Supracondylar Humerus (Extension Type)

Type I: Nondisplaced — anterior humeral line intersects capitellum; treat in long arm cast. Type II: Displaced with posterior cortex intact (hinge) — often closed reduction & pinning (CRPP). Type III: Completely displaced with no cortical contact — unstable; CRPP with two or three pins. Type IV (Leitch): Multidirectional instability (both cortices incompetent) — unstable under fluoroscopy; pin spread critical.

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Gustilo–Anderson — Open Fractures

I: 10 cm/high-energy or extensive damage. IIIa: adequate coverage; IIIb: periosteal stripping, needs flap; IIIc: arterial injury requiring repair. Higher grade → higher infection/nonunion; guides antibiotics, debridement, coverage.

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Hardcastle–Myerson — Lisfranc Injuries

A: total incongruity; B1: medial partial; B2: lateral partial; C1: divergent partial; C2: divergent complete. Any >2 mm displacement typically requires surgical fixation/arthrodesis.

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Hawkins Classification — Talar Neck

I: no dislocation; II: subtalar dislocation; III: subtalar + tibiotalar; IV: plus talonavicular. AVN risk escalates I→IV; displaced types require urgent reduction and fixation.

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Herbert Classification — Scaphoid

A: acute stable (A1 tubercle, A2 nondisplaced waist). B: acute unstable (B1 distal oblique, B2 displaced waist, B3 proximal pole, B4 comminuted, B5 perilunate). C: delayed union; D: established nonunion. Unstable (B) often need fixation; D needs grafting + fixation.

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Hertel Predictors — Proximal Humerus Ischemia

Medial hinge disruption >2 mm, anatomic neck fracture, head-splitting → high AVN risk. Assists decision towards arthroplasty in ischemic patterns.

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Hip Labral Tears — Classification, Diagnosis & Arthroscopic Management

Detailed guide to hip labral tears covering anatomy, Seldes/Czerny classification, clinical tests, MR arthrography, arthroscopic repair vs debridement vs reconstruction, and outcomes.

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