Universal long bone defect classification

Abstract

Introduction: Treatment of long bone defects is a challenging problem in orthopedics that requires a robust and comprehensive classification system to guide diagnosis and management. The Universal Long Bone Defect Classification (ULBDC) is an alphanumeric system detailing the size and location of the defect. It is designed to describe the bone defect and indicate the appropriate treatment for both diaphyseal and articular long bones defects. Methods: The location, size, and morphology of the bone defect are the main criteria used in the treatment of both extra-articular and intra-articular bone defects. The proposed classification system utilizes the following nomenclature for both periarticular defects and diaphyseal defects: location (bone and segment) and morphology (type, group, and subgroup). Discussion: The ULBDC is based the same principles of coding as the “gold standard” AO/OTA Fractures Classification system with alpha-numeric coding “from simple to complex.” The choice of treatment method depends on the type, group, and subgroup of the defect as described. The principles of treatment of diaphyseal defects, as well as the principles of treatment of extra-articular fractures, are based on the restoration of the alignment, length, and rotation of the segment. Bone shortening and deformity are considered bone defects because their treatment requires the use of the same principles (osteotomies, bone grafting, bone transport, or combination of these methods) as treating real bone defects. Conclusion: The proposed classification is an attempt to classify all types of long bone defects and its use in clinical practice and research will allow for optimal and standardized treatments for the various types of bone defects to improve the treatment outcomes.