In the AO classification of distal femur fractures, a fracture coded as '33-C3' represents:
- A Complete articular fracture, metaphyseal comminution — no cortical contact between metaphysis and diaphysis ✓
- B Extra-articular fracture, simple transverse pattern
- C Partial articular fracture, condylar in the sagittal plane
- D Intercondylar (T- or Y-shaped) fracture with intact metaphysis
Correct answer: A. Complete articular fracture, metaphyseal comminution — no cortical contact between metaphysis and diaphysis
Explanation
In the AO/OTA system: segment '33' designates the distal femur; 'A' = extra-articular, 'B' = partial articular (unicondylar), 'C' = complete articular (bicondylar/T-Y fracture). Subtype C3 adds metaphyseal comminution such that there is no cortical contact between the distal articular block and the femoral shaft after reduction — the most severe pattern, requiring a LISS plate or retrograde IM nail for stability. C1 is a simple articular and simple metaphyseal (T/Y, no comminution); C2 is a simple articular with comminuted metaphysis.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
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