The Comprehensive AOCMF Classification System: Radiological Issues and Systematic Approach

et al. 2014

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The AOCMF Classification Group developed a hierarchical three-level craniomaxillofacial classification system with increasing level of complexity and details. Within the midface (level 1 code 92), the level 2 system describes the location of the fractures within defined regions in the central and lateral midface including the internal orbit. This tutorial outlines the level 3 detailed classification system for fractures of the orbit. It depicts the orbital fractures according to the subregions defined as orbital rims, anterior orbital walls, midorbit, and apex. The system allows documentation of the involvement of specific orbital structures such as inferior orbital fissure, internal orbital buttress, the greater wing of sphenoid, lacrimal bone, superior orbital fissure, and optic canal. The classification system is presented along with rules for fracture location and coding, a series of case examples with clinical imaging and a general discussion on the design of this classification.

Section: Case Examplesmentioning

confidence: 99%

The Comprehensive AOCMF Classification System: Orbital Fractures - Level 3 Tutorial

et al. 2014

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“…The imaging requirements for this classification are discussed in a companion article in this issue. 3…”

Section: Outer and Inner Surface Of The Mandiblementioning

confidence: 99%

“…This level 3 classification attempt cannot go without 3D imaging to account for fracture morphology features. 3 Admittedly the present system is imperfect; following use and experience in documentation, it will be possible to understand its limitations and consider adequate improvements.…”

Section: Concluding Notementioning

confidence: 99%

The Comprehensive AOCMF Classification System: Mandible Fractures-Level 3 Tutorial

et al. 2014

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The level 1 as the most elementary CMF classification serves to identify the presence of mandibular fractures, 1 irrespective of their description in location, number, pattern, or morphology. The level 2 classification system sets minimal standards for the assessment and documentation of CMF fractures, allowing the description of the fracture topography within defined regions based on the examination of diagnostic X-rays and/or CT imaging. This tutorial focuses on noncondylar mandibular fractures. It is organized in a sequence of sections starting with the imaging anatomy and its nomenclature, followed by a description of the classification system with illustrations of the topographical mandibular regions. AbstractThis tutorial outlines the details of the AOCMF image-based classification system for fractures of the mandible at the precision level 2 allowing description of their topographical distribution. A short introduction about the anatomy is made. Mandibular fractures are classified by the anatomic regions involved. For this purpose, the mandible is delineated into an array of nine regions identified by letters: the symphysis/ parasymphysis region anteriorly, two body regions on each lateral side, combined angle and ascending ramus regions, and finally the condylar and coronoid processes. A precise definition of the demarcation lines between these regions is given for the unambiguous allocation of fractures. Four transition zones allow an accurate topographic assignment if fractures end up in or run across the borders of anatomic regions. These zones are defined between angle/ramus and body, and between body and symphysis/parasymphysis. A fracture is classified as "confined" as long as it is located within a region, in contrast to a fracture being "nonconfined" when it extents to an adjoining region. Illustrations and case examples of mandible fractures are presented to become familiar with the classification procedure in daily routine.

“…Additional case examples are presented in a case collection appendix in this special issue. 95 Buitrago-Téllez et al 96 provide detailed information and discussion about imaging issues in this coding process.…”

Section: Case Examplesmentioning

confidence: 99%

The Comprehensive AOCMF Classification System: Midface Fractures - Level 3 Tutorial

et al. 2014

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Fractures of the midface occur in a high variety of fracture patterns and are difficult to classify appropriately to assign standardized categories of fracture classes reflecting the injury status of the patient. Requirements for a fracture classification are its clinical relevance and the ability to provide reliable and reproducible means to communicate Keywords ► fracture classification ► midface ► anatomic regions AbstractThe AOCMF Classification Group developed a hierarchical three-level craniomaxillofacial classification system with increasing level of complexity and details. The highest level 1 system distinguish four major anatomical units including the mandible (code 91), midface (code 92), skull base (code 93), and cranial vault (code 94). This tutorial presents the level 2 system for the midface unit that concentrates on the location of the fractures within defined regions in the central (upper, intermediate, and lower) and lateral (zygoma, pterygoid) midface, as well as the internal orbit and palate. The level 2 midface fracture location outlines the topographic boundaries of the anatomical regions. The common nasoorbitoethmoidal and zygoma en bloc fracture patterns, as well as the time-honored Le Fort classification are taken into account. This tutorial is organized in a sequence of sections dealing with the description of the classification system with illustrations of the topographical cranial midface regions along with rules for fracture location and coding, a series of case examples with clinical imaging and a general discussion on the design of this classification. Individual fracture mapping in these regions regarding severity, fragmentation, displacement of the fragment or bone defect is addressed in a more detailed level 3 system in the subsequent articles.