Differences And Classification Of Depalma And Cautilli
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DePalma and Cautilli first emphasized the difference between fractures with and without dislocation of the joint surfaces. Neer subsequently modified and emphasized this fracture type in his classic four-part classification scheme.
Codman in 1934 was the first to observe that there were four major fracture fragments when a proximal humerus fracture occurred, and that these occurred in varying combinations depending on the mechanism of injury . These fragments were the articular head, the greater and lesser tuberosities, and the humeral shaft.1,2,122
He classified proximal humerus fractures based on anatomical level of fracture 1. Supratubercular 2. Pertubercular 3. Infratubercular 4. Subtubercular
Disadvantage of this system is that it doesn’t allow for multiple fracture at different level , nor does it differentiate displaced from undisplaced fractures , which require different management .
Watson and Jones Classification It is based on mechanism of injury mainly for surgical neck fractures. 1. Abduction type 2. Adduction type.
The deformity in these fracture type is anterior angulation. Disadvantage of this…show more content… He modified and improved on Codman's classification by emphasizing patterns and degree of displacement rather than the location of fracture lines. He believed this gave important insight into humeral articular segment He emphasized the prognostic importance of fracture-dislocations, which he felt had a high likelihood of osteonecrosis due to loss of soft tissue attachments to the humeral head . According to Neer , a fracture fragment is considered displaced if there is more than 1 centimetre of separation or a fragment is angulated more than 45 degree from the adjacent fragment. If displacement is less than this, then the fracture is considered to be “minimally displaced” regardless of the number of fracture lines(Fig