The Nunley-Vertullo classification is one of several classification systems used for the categorization of Lisfranc injuries. It is based on clinical, x-ray and bone scan findings and also associates the stages with management options or recommendations regarding those injuries 1-3.
On this page:
Images:
Usage
The Nunley-Vertullo classification system is used for the grading of more subtle Lisfranc injuries or midfoot sprains and utilizes the following parameters 1-3:
- clinical symptoms as midfoot pain
- positive bone scan
- first to second metatarsal distance on weight-bearing dorsoplantar radiographs of the foot
- height of the medial longitudinal arch on a weight-bearing lateral radiograph of the foot
Classification system
Type 1
- midfoot pain, inability to participate in sports
- no displacement on weight-bearing radiographs
- positive bone scan
- indicates ligament sprain
Type 2
- diastasis of 1-5 mm between the first and second metatarsal base
- no decline of the medial longitudinal arch
- indicates a subtle ligament injury
Type 3
- diastasis of ≥5 mm between the first and second metatarsal base
- loss of medial longitudinal arch height (decline in distance between the medial cuneiform and fifth metatarsal)
- indicates a more severe injury
Based on the classification the authors recommended conservative non-operative management for type 1 injuries and anatomical reduction and fixation for type 2 and type 3 injuries 2,3.
History and etymology
This classification system was developed by the American orthopedic surgeons James A Nunley and Christopher J Vertullo in 2002 1.
Unable to process the form. Check for errors and try again.