Type I

Minimal or no comminution; if comminution is present, there is involvement of 25% or less of the bony circumference

Type II

Comminuted fragments involve up to 50% of the width of the bone

Type III

Comminuted fragment involves more than 50% of the width of the bone; leaves only a small area of contact between the proximal and distal fragments

Type IV

Comminution involves the entire bony circumference; no cortical contact


Femoral shaft fractures are often described in terms of the level at which they occur (proximal, middle, distal third) and configuration (spiral, transverse, oblique, segmental, comminuted). In 1980, Winquist proposed a classification based on fracture comminution.



Provide the citation for the landmark article and recent review articles describing the classification


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