Winquist classification of femoral shaft fractures

Last revised by Yuranga Weerakkody on 9 Aug 2022

The Winquist classification of femoral shaft fractures is based on fracture comminution and was proposed by Winquist in 1980. This classification is used with regards to management decision making, in determining whether a fracture requires an intramedullary nail or open reduction. 

  • type 0: no comminution or a small butterfly fragment less than 25 % of the width of the bone
  • type I: small butterfly fragment less than 25 % of the width of the bone
  • type II: butterfly fragment 50 % or less of the width of the bone
  • type III: comminuted with a large butterfly fragment, greater than 50 % of the width of the bone
  • type IV: severe comminution of an entire segment of bone (segmental comminution)

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