Rorabeck I & II

Define Fracture Pattern

The Lewis Rorabeck classification does not describe the specific fracture in terms of the fracture pattern, bone quality or the prosthesis. In order to plan the reduction and fixation, different reduction techniques are possible.For Example in two part long spiral fractures (OTA Type 32 A1 or 33 A1) reduction can be achieved directly (forceps and cerclage wire/ lag screw)Therefore it is important to classify the fracture pattern according to the OTA classification.[1]

[1] Rüedi, T.P.; Buckley, R.E.; Moran, C.G.: AO Principles of Fracture Management – Second expanded edition, Volume 1-2; AO Publishing; Switzerland

Case Study: Reduction of Rorabeck I & II  simple fracture

The reduction of a simple fracture pattern e.g. a two part spiral fractures (OTA type 32 or 33-A1) can be achieved by using an open or mini-open approach. The incision has to be long enough to sufficiently expose the fracture region. The two fragments are reduced by the help of forceps until optimal contact with anatomical alignment of axis and rotation is achieved. The reduction forceps are then replaced by cerclage wires or cables or a lag screw.

Define Fracture Pattern

The Lewis & Rorabeck classification does not describe the specific fracture in terms of the fracture pattern, bone quality or the prosthesis. In order to plan the reduction and fixation, different reduction techniques are possible. In short oblique or in multi-fragmented fractures (OTA Type 32 A2 – C3 or 33 A2 – A3) when the fracture can not be directly reduced and not be fixed by a cable the fracture zone is bridged. The plate is used as a reduction template. Therefore it is important to classify the fracture pattern according to the OTA classification[1].

[1] Rüedi, T.P.; Buckley, R.E.; Moran, C.G.: AO Principles of Fracture Management – Second expanded edition, Volume 1-2; AO Publishing; Switzerland

Case Study: Reduction of Rorabeck II complex fracture


The reduction of a multifragmentary fracture pattern e.g. a two part  spiral fractures (OTA Type 32 A2 – C3 or 33 A2 – A3) can be achieved by using a minimally invasive approach and totally closed reduction. This can be achieved by ligamentotaxis and/or the application of the plate as a template. After the plate has been inserted and temporarily fixed with K-wires, the final reduction can be achieved by seating the first shaft screw . The plate then acts as a reduction tool.