Anatomical illustration of a human proximal humerus depicting a displaced two-part fracture pattern. The diagram shows the humeral head, anatomical neck, and greater tuberosity regions. Red highlighted lines indicate fracture sites: a primary transverse fracture line across the surgical neck of the humerus and a secondary vertical fracture line involving the greater tuberosity and superior humeral head. The bone is rendered in a tan color with a gray articular surface for the glenoid fossa. This visual aid is designed for orthopedic education, specifically demonstrating the common components of Neer classification for proximal humeral fractures before surgical reduction and internal fixation.

A comparison chart consisting of four 3D CT reconstructions (a-d) of the proximal humerus, illustrating the modified Neer classification system for humeral fractures based on fragment displacement and angulation. Each panel shows two views of the shoulder joint to demonstrate spatial relationships between the humeral head, greater tuberosity, lesser tuberosity, and humeral shaft. (a) 1-part fracture: Minimal to no displacement or angulation between segments; the humeral head maintains alignment with the shaft and tuberosities. (b) 2-part fracture: Visible fracture line with rotation or displacement (>1cm or >45°) of the humeral head and tuberosities relative to the shaft. (c) 3-part fracture: Separation involving three segments, typically with the humeral head detached from both the shaft and the greater tuberosity. (d) 4-part fracture: Complete detachment and significant displacement of the humeral head from the other three proximal humeral segments (shaft, greater, and lesser tuberosities). This visual resource is intended for orthopedic surgical education, specifically for classifying fracture severity and assessing articular surface vascular risk.

Diagnostic CT images of a right proximal humerus fracture (Neer type 4) demonstrating standardized radiological measurement techniques for fracture classification and fragment displacement. Panel A (coronal view) illustrates the head-shaft angle (HSA) measurement, utilizing a green line along the humeral shaft axis and a line intersecting the anatomical neck plane to assess for varus or non-varus alignment. Panel B (coronal view) displays the measurement of cranial displacement of the greater tuberosity in millimeters, indicated by vertical green markers. Panel C (axial view) shows the measurement of dorsal displacement of the greater tuberosity using an angular calculation. Across all panels, red outlines denote key anatomical fragments including the humeral head and greater tuberosity. These images provide a clinical methodology for evaluating orthopedic trauma, specifically relating to humeral head fractures and accompanying rotator cuff fragment position, which is critical for determining surgical intervention and prognostic outcomes in adult orthopedic medicine.

Anteroposterior (AP) radiograph of the right shoulder demonstrating a complex, comminuted proximal humerus fracture in an adult patient. According to the Neer classification system, this appears to be a 4-part fracture involving the surgical neck, the anatomical neck, and the greater tuberosity. Significant cortical disruption is visible, with multiple distinct bone fragments exhibiting displacement and angulation relative to the humeral shaft. The articular surface of the humeral head shows signs of involvement and spatial malalignment within the glenohumeral joint. There is also a visual suggestion of displacement of the greater tuberosity fragment. Radiopaque surgical clips are present in the soft tissues lateral to the humerus, likely from a previous or concurrent surgical procedure. The imaging is consistent with high-energy trauma or osteoporotic fragility fracture, illustrating the pedagogical challenge of identifying specific fracture lines in cases of severe comminution and overlapping fragments.

This diagnostic image consists of two Computed Tomography (CT) scan views (scout or 3D reformations) of the proximal humerus, demonstrating a complex 4-part fracture according to the Neer classification system. The image highlights a highly comminuted fracture involving the superior extremity of the humerus. Four distinct fragments are identified with red numerical labels (1 through 4): the articular humeral head, the greater tuberosity, the lesser tuberosity, and the humeral shaft (diaphysis). There is significant displacement and loss of anatomical alignment between the humeral head fragments and the surgical neck. The views (likely anteroposterior and a secondary oblique or axial orientation) provide a multi-planar assessment of the fracture pattern, crucial for surgical planning such as internal fixation with locking plates or arthroplasty. This clinical finding is typical of high-energy trauma in younger patients or low-energy falls in osteoporotic elderly populations within the domain of orthopedic traumatology.

This diagnostic image is a Computed Tomography (CT) scan of the right shoulder, showing a severe proximal humerus fracture. The visual demonstrates a Neer four-part fracture pattern, characterized by the distinct separation and displacement of four major anatomical segments: the humeral head, the greater tuberosity, the lesser tuberosity, and the humeral shaft. An arrow points to the primary fracture site where significant cortical discontinuity is evident. There is a clear loss of normal anatomical alignment, with the humeral head appearing angulated and displaced relative to the glenoid fossa and the humeral shaft. The comminuted nature of the injury is visible through multiple bone fragments in the subacromial and glenohumeral regions. This image is used in medical education to illustrate complex orthopedic trauma, the Neer classification system for proximal humerus fractures, and the surgical considerations for management such as ORIF versus arthroplasty.

This diagnostic comparison chart presents six 3D reconstructions (labeled a–f) of a human left tibial plateau in an axial view, demonstrating fracture mapping across Schatzker types I–VI. Red lines represent anatomical fracture trajectories mapped onto a standard 3D tibial model. Panels 'a', 'b', and 'c' illustrate fractures primarily involving the lateral tibial plateau, consistent with Schatzker types I (pure cleavage), II (cleavage with depression), and III (pure depression). Panel 'b' specifically shows a higher density of comminution compared to 'a'. Panel 'd' represents Schatzker type IV, showing fracture lines localized to the medial plateau. Panels 'e' and 'f' represent Schatzker types V (bicondylar) and VI (bicondylar with metadiaphyseal dissociation), respectively, exhibiting extensive, high-density fracture networks that cross both medial and lateral compartments and the intercondylar eminence. This anatomical diagram serves as an educational tool for orthopedic surgical planning, highlighting fracture morphology and the distribution of mechanical failure across different injury mechanisms.

A series of eight grayscale heat maps (labeled a–h) illustrating the frequency and anatomical distribution of articular depression zones in various Schatzker classifications of tibial plateau fractures. The maps utilize a gray-value intensity scale to represent the incidence of depression at specific locations on the tibial plateau surface, with darker shades indicating higher frequency. (a-c) Schatzker type II subtypes: single anterolateral fracture (SALF) shows dense anterolateral depression; single posterolateral fracture (SPLF) shows a localized posterolateral zone; and complex fracture (CF) demonstrates a broad anterolateral distribution extending medially. (d) Schatzker type III shows concentrated lateral depression. (e-f) Schatzker type IV subtypes: single anteromedial fracture (SAMF) and whole medial fracture (WMF) showing varied medial plateau involvement. (g) Schatzker type V shows predominant posterolateral depression. (h) Schatzker type VI displays a central concentration of depression spanning the lateral and medial transition. This diagnostic illustration serves as an orthopedic educational tool for understanding fracture morphology and predicting articular surface damage based on fracture classification.

This diagnostic image displays two coronal CT reconstructions of the knee, illustrating different patterns of lateral tibial plateau fractures according to the Schatzker classification system. Image A shows a Schatzker Type I fracture, characterized by a simple vertical split of the lateral tibial condyle without significant depression of the articular surface. The fracture line is clean and extends from the lateral articular margin down into the metaphysis. Image B demonstrates a Schatzker Type II fracture, which consists of a lateral condylar split combined with a central articular depression. This depression is visible as a vertical 'step-off' in the joint surface, indicating a more complex injury mechanism typically involving both axial loading and valgus stress. Both images provide a clear comparison of articular congruity versus displacement, which is essential for determining surgical management. These patterns are common in orthopedic trauma and are critical for medical students and residents to differentiate during radiological assessment of knee injuries.

Anteroposterior (AP) pre-operative X-ray of the knee demonstrating a high-energy Schatzker type VI tibial plateau fracture. The diagnostic image shows a complex, comminuted fracture involving both the medial and lateral tibial condyles with significant disruption of the articular surface. A hallmark of the type VI classification is the complete dissociation between the tibial plateau (epiphysis/metaphysis) and the tibial shaft (diaphysis), visible here as multiple vertical and horizontal fracture lines extending through the proximal tibia. There is evident displacement of bone fragments and loss of joint congruity. Key landmarks including the distal femur and proximal fibula are visible, though the primary pathology is localized to the proximal tibia. This image is clinically significant for orthopedic surgical planning, highlighting the need for restoration of articular alignment and stable internal fixation in a multi-planar fracture pattern.

This diagnostic radiographic image consists of two views of the knee: (a) an antero-posterior (AP) view and (b) a lateral view, demonstrating a complex bicondylar tibial plateau fracture classified as Schatzker Type VI. The AP view reveals extensive comminution and disruption of both the medial and lateral tibial condyles, with multiple fracture lines extending from the articular surface through to the metaphysis. Significant distortion of the tibial plateau's anatomical contour is evident, along with a fracture of the proximal fibula. The lateral view demonstrates a complete dissociation between the tibial metaphysis and diaphysis. There is visible articular incongruity, depression of the joint surface, and significant anterior-posterior displacement of the fracture fragments. The images illustrate a high-energy orthopedic injury characterized by metaphyseal-diaphyseal discontinuity, which is the defining feature of the Schatzker VI classification. This content is highly relevant for orthopedic surgical planning, trauma education, and musculoskeletal radiology indexing.

A multi-panel figure illustrating a biomechanical study of lateral tibial plateau depression fractures (Schatzker type III) using synthetic bone models. Panels (a) and (b) show the generation of a 15 mm deep depression fracture on the lateral tibial plateau using an axial indentor. Panel (c) provides a schematic diagram of the biomechanical test setup, showing a shortened tibia embedded in a metal device with axial force applied by a load cell. Panels (d), (e), and (f) demonstrate the step-by-step anatomical reduction process mimicking the Arthroscopic Reduction and Internal Fixation (ARIF) technique: (d) illustrates the lateral metaphyseal approach using a drill to create an entry point; (e) shows a Kirschner-wire (K-wire) used to detect and guide the depressed fragment; and (f) demonstrates the use of a cannulated ram to elevate the articular surface back to its anatomical position. This content serves to teach orthopedic trauma management, specifically the minimally invasive reduction of intra-articular proximal tibia fractures.

This composite panel illustrates the surgical management and healing progression of a comminuted patellar fracture in a 73-year-old patient. The diagnostic phase includes a lateral radiograph (A) and 3D CT reconstruction (B), demonstrating a displaced fracture with articular discontinuity. Intraoperative photographs show the minimally invasive technique: preoperative skin markings for dual transverse incisions (C), and the application of two-pointed bone reduction forceps (D). Postoperative radiographs (E, F) in lateral and anteroposterior views confirm successful fracture reduction and internal fixation using a combination of vertical Kirschner wires and a figure-of-eight tension-band titanium cable system. The clinical photographs document the wound healing timeline: (G) shows the immediate postoperative appearance with fresh sutures and localized ecchymosis, while (H) shows the three-month follow-up where the two small transverse scars are well-healed, showing minimal erythema and significant resolution of surrounding bruising. This series highlights orthopedic surgical principles including anatomical reduction, stable internal fixation, and the benefits of minimally invasive approaches in elderly populations.

This diagnostic image is a coronal CT scan focused on the patella of the right knee. The scan demonstrates a comminuted patellar fracture, characterized by multiple fracture lines indicated by red arrows. Two distinct vertical fracture planes are visible, dividing the patella into at least three separate fragments. These fracture lines extend through the bony matrix, disrupting the cortical integrity and smoothing of the articular surface. The surrounding soft tissues show uniform density without gross displacement, though the primary focus remains on the integrity of the patellar bone. This image is illustrative of orthopedic trauma and the use of advanced imaging in assessing complex fracture patterns for surgical planning. It is intended for medical students and orthopedic residents to understand the classification and visualization of intra-articular knee fractures.

Multi-planar pre-operative Computed Tomography (CT) scan images of a left knee demonstrating complex traumatic fractures. Images A and B (axial views) show a minimally displaced transverse fracture through the inferior aspect of the patella and a comminuted fracture of the proximal tibia with cortical breaching. Image C (sagittal view) highlights an avulsion-type fracture of the tibial tuberosity. Image D (coronal view) reveals a vertical-oblique fracture line extending superiorly toward the tibial plateau, involving the intercondylar notch and causing a depressed fragment of the lateral tibial condyle. This clinical imaging set illustrates a synchronous injury involving both the extensor mechanism (patellar fracture) and the proximal tibial articular surface, specifically a type 4 pattern injury according to clinical classification. The diagnostic imaging is critical for surgical planning of open reduction and internal fixation (ORIF).

This composite figure illustrates the surgical management of a complex, comminuted patellar fracture (AO/OTA 34-C3). The left image is an intraoperative clinical photograph showing an open reduction and internal fixation (ORIF) procedure. Two parallel longitudinal 2.4 mm locking compression miniplates are positioned anteriorly, joined by a transverse plate to create a stable framework across the fracture fragments. Multiple color-coded locking screws are visible, securing the low-profile plates to the patellar bone. The right image is a corresponding anteroposterior (AP) fluoroscopic radiograph. It demonstrates the radiopaque hardware, including the miniplate construct and several long cannulated or locking screws, bridging the multi-fragmentary fracture lines. The radiographic view confirms the anatomical reduction of the patella and the multidirectional stabilization provided by the variable-angle locking system. This technique is typically employed for highly comminuted fractures where traditional tension band wiring may be insufficient for rigid fixation and early mobilization.

This composite educational resource illustrates a non-displaced stellate patellar fracture through four complementary views: (a) a medical illustration showing multiple radiating fracture lines, (b) an anteroposterior (AP) radiograph of the knee, (c) a sagittal fat-suppressed proton density (PD) MRI, and (d) a coronal fat-suppressed PD MRI. The AP radiograph reveals subtle lucent lines within the patella body (arrows). The MR images provide superior visualization of the multi-fragmentary, comminuted fracture pattern without significant displacement of the osseous fragments. The sagittal MRI (c) highlights hyperintense signal intensity in the prepatellar soft tissues (arrowheads), characteristic of subcutaneous oedema resulting from direct blunt trauma. This series serves as a clinical teaching tool for musculoskeletal radiology, emphasizing that patellar fractures occult or subtle on conventional radiography are better characterized using advanced imaging like MRI to assess for articular involvement and associated soft tissue injury.

Two-part intraoperative clinical photograph demonstrating a 'three-dimensional strapping reduction' technique for a comminuted patellar fracture. Panel (a) shows the initial surgical exposure through a vertical incision, revealing multiple irregular bone fragments of the patella. Heavy blue non-absorbable sutures are seen being threaded from the fracture end through the patellofemoral joint into the surrounding soft tissue, with surgical forceps manipulating the tissue. Panel (b) illustrates the reduction phase where the sutures are gathered and tightened toward the center, effectively approximating the bone fragments under direct vision. The sutures are tied on the anterior surface of the patella, creating a stabilized construct before definitive internal fixation. This orthopedic procedure is designed to achieve anatomical reduction of the articular surface and the patellofemoral joint in complex fracture patterns.