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.

ComponentsClassification systemsVariablesDescriptions

Fundamental elements
 Time codeD−Time of presentation
DBefore surgical repair
D+Immediately postop
D+nMn months postop; W for weeks; Y for years
 Subscapularis Lafosse et al. [4]0, 1–5(Table 1)
 Long head of bicepsBNBiceps is normal
BPBiceps is pathological
BABiceps is absent or tenotomized
BTBiceps is tenodesed
 SupraspinatusPatte [7]0, 1–3(Figure 4)
 Teres minor
Secondary elements
 ACACAC joint is arthritic
ACRs/p AC joint resection
 Glenohumeral arthritis Samilson and Prieto [8]GH1–3(Table 2)
 Labrum Synder et al. [16]SL1–7SLAP tear (Table 3)
SLDStatus post SLAP debridement
SLRStatus post SLAP repair
Lx-y Labral detachment from x to y o’clock
LDStatus post labral debridement
LRStatus post labral repair
 Tear configurationUU-shaped tear
VV-shaped tear
ALAnterior L-shaped tear with anterior corner detachment
PLPosterior L-shaped tear with posterior corner detachement
 Partial thickness tearEllman [2]A1–3Articular-sided tear, (Table 4)
B1–3Bursal-sided tear, (Table 4)
IInterstitial tear
  Calcific tendonitisCPresence of calcific tendonitis
  Fatty infiltration Goutallier et al. [10]Gabcd Subscapularis, supraspinatus, infraspinatus, teres minor (Table 5)
  Nerve pathologySSNSuprascapular nerve injury
SSNRStatus post SSN release
AXNAxillary nerve injury
LTNLong thoracic nerve injury