AO/OTA classification of proximal tibial fractures

Last revised by Joachim Feger on 9 Sep 2021

The AO/OTA classification is one of the most frequently used systems for classifying proximal tibial fractures or proximal tibial end segment fractures. Like other fractures, they are divided into three groups subject to the severity and complexity of the respective injury 1:

  • type A: extraarticular proximal tibial end segment fracture
    • A1: proximal tibial avulsion fracture
      • A1.1 capsular attachment avulsion: lateral(Segond fracture)/medial
      • A1.2 tibial tuberosity avulsion (patella tendon)
      • A1.3 tibial spine fracture: anterior/posterior
    • A2: simple extraarticular proximal tibial fracture
      • A2.1 spiral proximal tibial fracture
      • A2.2 oblique proximal tibial fracture 
      • A2.3 transverse proximal tibial fracture
    • A3: extraarticular wedge or multifragmentary proximal tibial fracture
      • A3.1 intact wedge fracture: lateral/medial
      • A3.2 fragmentary wedge fracture: lateral/medial
      • A3.3 multifragmentary fracture
  • type B: partial articular proximal tibial end segment fracture
    • B1: pure split fracture
      • B1.1 lateral plateau split fracture
      • B1.2 medial plateau split fracture
      • B1.3 oblique fracture with involvement of the tibial spine: lateral/medial
    • B2: pure depression fracture
      • B2.1 lateral plateau depression: anterolateral/posterolateral/central
      • B2.2 medial plateau depression: anteromedial/posteromedial/central
    • B3: partial articular split depression fracture
      • B3.1 lateral plateau split depression: anterolateral/posterolateral/central
      • B3.2 medial plateau split depression: anteromedial/posteromedial/central
      • B3.3 oblique fracture with involvement of the tibial spine: lateral/medial
  • type C: complete articular proximal tibial end segment fracture
    • C1: simple articular and metaphyseal fracture
      • C1.1 without intercondylar eminence fragment
      • C1.2 with intercondylar eminence fragment
    • C2: simple articular wedge or multifragmentary metaphyseal fracture
      • C2.1 intact wedge fracture: lateral/medial
      • C2.2 fragmentary wedge fracture: lateral/medial
      • C2.3 multifragmentary fracture
    • C3: with fragmentary or multifragmentary articular and metaphyseal fracture*
      • C3.1 fragmentary lateral plateau
      • C3.2 fragmentary medial plateau
      • C3.3 multifragmentary medial and lateral plateau fracture

*applies for anterolateral/posterolateral/anteromedial/posteromedial/central simple metaphyseal or multifragmentary metaphyseal fractures with or without metadiaphyseal extension

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