Distal radius fracture classification
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rohan A. Bhimani, M.B.B.S., D.N.B., M.Ch.[2]
Overview
There are multiple classifications available for distal radius fractures. The most common classification systems for distal radius fractures include Frykman, Melone, Fernández, Universal, and AO classification.
Classification
There are multiple classifications available for distal radius fractures. The most common classification systems for distal radius fractures include Frykman (1967), Melone (1984), Fernández (2001), Universal (Cooney 1993), and AO classification (Marsh et al. 2007).
Frykman Classification
- Frykman classified distal radius fracture based on location.[1]
| Frykman Classification | |
|---|---|
| I | Extra-articular |
| II | Extra-articular with ulnar fracture |
| III | Intra-articular into radiocarpal joint |
| IV | Intra-articular into radiocarpal joint with ulnar fracture |
| V | Intra-articular into radioulnar joint |
| VI | Intra-articular into radioulnar joint with ulnar fracture |
| VII | Intra-articular into radiocarpal + radioulnar joints |
| VIII | Intra-articular into radiocarpal + radioulnar joints with ulnar fracture |
Melone Classification
- Melone classified distal radius fracture based on location.[2][3]
| Melone Classification | ||
|---|---|---|
| I | Undisplaced, no or minimal comminution | |
| II | Die punch fracture with moderate to severe displacement | |
| A | Reducible | |
| B | Irreducible | |
| III | Spike fragment present | |
| IV | Wide separation of intra-articular fragments | |
| V | Explosion fracture with severe comminution, transverse split and rotational displacement | |
Fernández Classification
- Fernández classified distal radius fracture based on trauma mechanism.[4]
| Fernández Classification | |
|---|---|
| Type 1 | Bending fracture of metaphysis |
| Type 2 | Shearing fracture of joint surface |
| Type 3 | Compression fracture of joint surface |
| Type 4 | Avulsion fractures or radiocarpal fracture-dislocation |
| Type 5 | Combined fractures associated with high high-velocity injuries |
Universal Classification
- Cooney classified distal radius fracture based on location and stability.[5]
| Universal Classification | ||
|---|---|---|
| Type 1 | Extra-articular fracture, without deviation | |
| Type 2 | Extra-articular fracture, with deviation | |
| 2A | Reducible and stable | |
| 2B | Reducible and unstable | |
| 2C | Irreducible | |
| Type 3 | Intra-articular fracture, without deviation | |
| Type 4 | Intra-articular fracture, with deviation | |
| 4A | Reducible and stable | |
| 4B | Reducible and unstable | |
| 4C | Irreducible | |
OTA System
- AO/ASIF classification is the widely accepted classification.
- Radius is given the number 21 based on the classification.[6]
- It is further subdivided as:
| OTA System | ||
|---|---|---|
| A | Extra-articular fractures | |
| A1 | Ulnar fracture, radius intact | |
| A2 | Radius fracture, simple and impacted | |
| A3 | Radius fracture, multifragmentary | |
| B | Partial articular fractures | |
| B1 | Radius fracture, sagittal | |
| B2 | Radius fracture, frontal, dorsal rim | |
| B3 | Radius fracture, frontal, volar rim | |
| C | Complete articular fractures | |
| C1 | Articular simple + metaphyseal simple | |
| C2 | Articular simple, metaphyseal multifragmentary | |
| C3 | Articular multifragmentary | |
Types of Fractures based on Eponyms
Barton's Fracture
- Fracture-dislocation of radiocarpal joint (with intra-articular fracture involving the volar or dorsal lip)
Chauffer's Fracture
Colles'Fracture
- Dorsally displaced, extra-articular fracture
Die-punch Fracture
Smith's Fracture
- Volar displaced, extra-articular fracture
References
- ↑ Frykman G (1967). "Fracture of the distal radius including sequelae--shoulder-hand-finger syndrome, disturbance in the distal radio-ulnar joint and impairment of nerve function. A clinical and experimental study". Acta Orthop Scand: Suppl 108:3+. PMID 4175195.
- ↑ Melone CP (1993). "Distal radius fractures: patterns of articular fragmentation". Orthop Clin North Am. 24 (2): 239–53. PMID 8479722.
- ↑ Melone CP (1984). "Articular fractures of the distal radius". Orthop Clin North Am. 15 (2): 217–36. PMID 6728444.
- ↑ Fernandez DL (2001). "Distal radius fracture: the rationale of a classification". Chir Main. 20 (6): 411–25. PMID 11778328.
- ↑ Cooney WP (1993). "Fractures of the distal radius. A modern treatment-based classification". Orthop Clin North Am. 24 (2): 211–6. PMID 8479719.
- ↑ Arealis G, Galanopoulos I, Nikolaou VS, Lacon A, Ashwood N, Kitsis C (2014). "Does the CT improve inter- and intra-observer agreement for the AO, Fernandez and Universal classification systems for distal radius fractures?". Injury. 45 (10): 1579–84. doi:10.1016/j.injury.2014.06.017. PMID 25042062.