In the Winquist classification of comminuted femoral shaft fractures, a Type IV fracture is defined by:

• A Comminution involving less than 25% of the cortical circumference
• B More than 50% of the cortex remaining in contact between proximal and distal fragments
• C Loss of all cortical contact with no circumferential cortical continuity ✓
• D A single butterfly fragment less than 50% of the diameter

Explanation

Winquist Type IV denotes circumferential comminution with complete loss of cortical contact between the major fragments, so length and rotational stability depend entirely on the implant. In contrast, Type II retains more than 50% cortical contact and Type III retains less than 50%. Recognizing Type IV matters because these fractures are least stable and most dependent on locked intramedullary nail constructs.

Reference: Rockwood and Green's Fractures in Adults, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.