Winquist and Hansen classification of femoral shaft fractures
Citation, DOI, disclosures and article data
Citation:
Benoudina S, Knipe H, Weerakkody Y, et al. Winquist and Hansen classification of femoral shaft fractures. Reference article, Radiopaedia.org (Accessed on 22 Mar 2025) https://doi.org/10.53347/rID-48180
rID:
48180
Article created:
23 Sep 2016,
Samir Benoudina
Disclosures:
At the time the article was created Samir Benoudina had no recorded disclosures.
View Samir Benoudina's current disclosures
Last revised:
Disclosures:
At the time the article was last revised Henry Knipe had the following disclosures:
- Micro-X Ltd, Shareholder (past)
These were assessed during peer review and were determined to not be relevant to the changes that were made.
View Henry Knipe's current disclosures
Revisions:
7 times, by
6 contributors -
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Systems:
Sections:
Synonyms:
- Winquist–Hansen classification system
- Winquist & Hansen classification of femoral shaft fractures
- Winquist classification of femoral shaft fractures
The Winquist and Hansen classification of femoral shaft fractures is based on fracture comminution and stability.
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Usage
The Winquist system is commonly used along with the AO/OTA classification of femoral diaphyseal fractures 4.
This classification was originally used to assist (along with other factors) in deciding whether a fracture requires an intramedullary nail or open reduction, which was important at the time of the classification's publication 5. However, intramedullary nailing is now considered the gold standard (c. 2023) for femoral shaft fractures regardless of type 5,6.
Classification
type 0: no comminution or a small butterfly fragment <25% of the width of the bone
type I: small butterfly fragment <25% of the width of the bone
type II: butterfly fragment ≤50% of the width of the bone
type III: comminuted with a large butterfly fragment >50% of the width of the bone
type IV: severe comminution of an entire segment of bone (segmental comminution)
History and etymology
This classification system was proposed by Winquist and Hansen in 1980 1.
References
- 1. Winquist RA, Hansen Jr ST. Comminuted fractures of the femoral shaft treated by intramedullary nailing. Orthop Clin N Am. 1980;11(3):633–48.
- 2. Torres L, Lycans D, Goel A. Femoral Shaft Fractures. Orthopedic Surgery Clerkship. 2017;:291-7. doi:10.1007/978-3-319-52567-9_65
- 3. Kanakaris N & Giannoudis P. Femoral Shaft Fractures. Trauma and Orthopaedic Classifications. 2014;:325-6. doi:10.1007/978-1-4471-6572-9_73
- 4. Miao K & Miao J. Radiological Diagnosis and Imaging of Femoral Shaft Fractures. Anatomia. 2023;2(3):282-99. doi:10.3390/anatomia2030026
- 5. Kanakaris N & Giannoudis P. Femoral Shaft Fractures. Trauma and Orthopaedic Classifications. 2014;:325-6. doi:10.1007/978-1-4471-6572-9_73
- 6. Gupte D, Axelrod D, Worthy T, Woolnough T, Selznick A, Johal H. Management of Femoral Shaft Fractures: The Significance of Traction or Operative Position. Cureus. 2023;15(1):e33776. doi:10.7759/cureus.33776 - Pubmed
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