Nissen-Lie classification

Nissen-Lie classification is a medical classification system used in the field of Orthopedics. It is named after the Norwegian orthopedic surgeons Nils Nissen-Lie and Harald Nissen-Lie, who first proposed the system in the mid-20th century. The Nissen-Lie classification is primarily used to categorize fractures of the proximal femur, including hip fractures.

Overview

The Nissen-Lie classification is based on the anatomical location of the fracture and the direction of the fracture line. It divides proximal femur fractures into three main categories: intracapsular fractures, extracapsular fractures, and subtrochanteric fractures. Each of these categories is further subdivided based on specific characteristics of the fracture.

Intracapsular Fractures

Intracapsular fractures are those that occur within the hip joint capsule. According to the Nissen-Lie classification, these fractures can be further divided into femoral head fractures and femoral neck fractures. Femoral head fractures are rare and often associated with hip dislocations, while femoral neck fractures are more common, especially in older adults with osteoporosis.

Extracapsular Fractures

Extracapsular fractures occur outside the hip joint capsule. They are further divided into intertrochanteric fractures and greater trochanteric fractures in the Nissen-Lie classification. Intertrochanteric fractures occur between the greater and lesser trochanters of the femur, while greater trochanteric fractures involve the protrusion on the side of the hip.

Subtrochanteric Fractures

Subtrochanteric fractures occur below the lesser trochanter, in the region of the femur known as the subtrochanteric zone. These fractures are often the result of high-energy trauma and can be challenging to treat due to the complex anatomy and high forces in this area.

Clinical Significance

The Nissen-Lie classification is widely used in clinical practice and research to guide treatment decisions and predict outcomes for patients with proximal femur fractures. It provides a standardized language for describing these fractures, facilitating communication among healthcare professionals and comparison across studies.