Research Article
A Concise and Comprehensive Description of Shoulder Pathology and Procedures: The 4D Code System
Table 6
Summary of the elements of the 4D code with its possible codes and corresponding descriptions.
| Components | Classification systems | Variables | Descriptions |
| Fundamental elements | | | | Sidedness | | R | Right | | | L | Left | Time code | | D− | Time of presentation | | | D | Before surgical repair | | | D+ | Immediately postop | | | D+nM | n months postop; W for weeks; Y for years | Subscapularis |
Lafosse et al. [4] | 0, 1–5 | (Table 1) | Long head of biceps | | BN | Biceps is normal | | | BP | Biceps is pathological | | | BA | Biceps is absent or tenotomized | | | BT | Biceps is tenodesed | Supraspinatus | Patte [7] | 0, 1–3 | (Figure 4) | Infraspinatus | | | | Teres minor | | | | Secondary elements | | | | AC | | AC | AC joint is arthritic | | | ACR | s/p AC joint resection | Glenohumeral arthritis |
Samilson and Prieto [8] | GH1–3 | (Table 2) | Labrum |
Synder et al. [16] | SL1–7 | SLAP tear (Table 3) | | | SLD | Status post SLAP debridement | | | SLR | Status post SLAP repair | | | Lx-y | Labral detachment from x to y o’clock | | | LD | Status post labral debridement | | | LR | Status post labral repair | Tear configuration | | U | U-shaped tear | | | V | V-shaped tear | | | AL | Anterior L-shaped tear with anterior corner detachment | | | PL | Posterior L-shaped tear with posterior corner detachement | Partial thickness tear | Ellman [2] | A1–3 | Articular-sided tear, (Table 4) | | | B1–3 | Bursal-sided tear, (Table 4) | | | I | Interstitial tear | Calcific tendonitis | | C | Presence of calcific tendonitis | Fatty infiltration |
Goutallier et al. [10] | Gabcd | Subscapularis, supraspinatus, infraspinatus, teres minor (Table 5) | Nerve pathology | | SSN | Suprascapular nerve injury | | | SSNR | Status post SSN release | | | AXN | Axillary nerve injury | | | LTN | Long thoracic nerve injury |
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