Distal radius fracture classification: Difference between revisions
Jump to navigation
Jump to search
No edit summary |
No edit summary |
||
| Line 5: | Line 5: | ||
==Overview== | ==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. | There are multiple classifications available for [[Distal radius fracture|distal radius fractures]]. The most common classification systems for [[Distal radius fracture|distal radius fractures]] include Frykman, Melone, Fernández, Universal, and AO classification. | ||
==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).<ref name="pmid4175195">{{cite journal| author=Frykman G| title=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. | journal=Acta Orthop Scand | year= 1967 | volume= | issue= | pages= Suppl 108:3+ | pmid=4175195 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4175195 }} </ref><ref name="pmid11778328">{{cite journal| author=Fernandez DL| title=Distal radius fracture: the rationale of a classification. | journal=Chir Main | year= 2001 | volume= 20 | issue= 6 | pages= 411-25 | pmid=11778328 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11778328 }} </ref><ref name="pmid6728444">{{cite journal| author=Melone CP| title=Articular fractures of the distal radius. | journal=Orthop Clin North Am | year= 1984 | volume= 15 | issue= 2 | pages= 217-36 | pmid=6728444 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6728444 }} </ref><ref name="pmid8479722">{{cite journal| author=Melone CP| title=Distal radius fractures: patterns of articular fragmentation. | journal=Orthop Clin North Am | year= 1993 | volume= 24 | issue= 2 | pages= 239-53 | pmid=8479722 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8479722 }} </ref><ref name="pmid8479719">{{cite journal| author=Cooney WP| title=Fractures of the distal radius. A modern treatment-based classification. | journal=Orthop Clin North Am | year= 1993 | volume= 24 | issue= 2 | pages= 211-6 | pmid=8479719 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8479719 }} </ref><ref name="pmid25042062">{{cite journal| author=Arealis G, Galanopoulos I, Nikolaou VS, Lacon A, Ashwood N, Kitsis C| title=Does the CT improve inter- and intra-observer agreement for the AO, Fernandez and Universal classification systems for distal radius fractures? | journal=Injury | year= 2014 | volume= 45 | issue= 10 | pages= 1579-84 | pmid=25042062 | doi=10.1016/j.injury.2014.06.017 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25042062 }} </ref> | There are multiple classifications available for [[Distal radius fracture|distal radius fractures]]. The most common classification systems for [[Distal radius fracture MRI|distal radius fractures]] include Frykman (1967), Melone (1984), Fernández (2001), Universal (Cooney 1993), and AO classification (Marsh et al. 2007).<ref name="pmid4175195">{{cite journal| author=Frykman G| title=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. | journal=Acta Orthop Scand | year= 1967 | volume= | issue= | pages= Suppl 108:3+ | pmid=4175195 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4175195 }} </ref><ref name="pmid11778328">{{cite journal| author=Fernandez DL| title=Distal radius fracture: the rationale of a classification. | journal=Chir Main | year= 2001 | volume= 20 | issue= 6 | pages= 411-25 | pmid=11778328 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11778328 }} </ref><ref name="pmid6728444">{{cite journal| author=Melone CP| title=Articular fractures of the distal radius. | journal=Orthop Clin North Am | year= 1984 | volume= 15 | issue= 2 | pages= 217-36 | pmid=6728444 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6728444 }} </ref><ref name="pmid8479722">{{cite journal| author=Melone CP| title=Distal radius fractures: patterns of articular fragmentation. | journal=Orthop Clin North Am | year= 1993 | volume= 24 | issue= 2 | pages= 239-53 | pmid=8479722 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8479722 }} </ref><ref name="pmid8479719">{{cite journal| author=Cooney WP| title=Fractures of the distal radius. A modern treatment-based classification. | journal=Orthop Clin North Am | year= 1993 | volume= 24 | issue= 2 | pages= 211-6 | pmid=8479719 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8479719 }} </ref><ref name="pmid25042062">{{cite journal| author=Arealis G, Galanopoulos I, Nikolaou VS, Lacon A, Ashwood N, Kitsis C| title=Does the CT improve inter- and intra-observer agreement for the AO, Fernandez and Universal classification systems for distal radius fractures? | journal=Injury | year= 2014 | volume= 45 | issue= 10 | pages= 1579-84 | pmid=25042062 | doi=10.1016/j.injury.2014.06.017 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25042062 }} </ref> | ||
===Frykman Classification=== | ===Frykman Classification=== | ||
* Frykman classified distal radius fracture based on Location | * Frykman classified [[distal radius fracture]] based on Location | ||
{| class="wikitable" | {| class="wikitable" | ||
|+ | |+ | ||
| Line 21: | Line 21: | ||
|- | |- | ||
|II | |II | ||
|Extra-articular with ulnar fracture | |Extra-articular with [[ulnar fracture]] | ||
|- | |- | ||
|III | |III | ||
|Intra-articular into radiocarpal joint | |Intra-articular into [[radiocarpal joint]] | ||
|- | |- | ||
|IV | |IV | ||
|Intra-articular into radiocarpal joint with ulnar fracture | |Intra-articular into [[radiocarpal joint]] with [[ulnar fracture]] | ||
|- | |- | ||
|V | |V | ||
|Intra-articular into radioulnar joint | |Intra-articular into [[radioulnar joint]] | ||
|- | |- | ||
|VI | |VI | ||
|Intra-articular into radioulnar joint with ulnar fracture | |Intra-articular into [[radioulnar joint]] with [[ulnar fracture]] | ||
|- | |- | ||
|VII | |VII | ||
|Intra-articular into | |Intra-articular into [[radiocarpal]] + radioulnar joints | ||
|- | |- | ||
|VIII | |VIII | ||
|Intra-articular into | |Intra-articular into [[radiocarpal]] + radioulnar joints with [[ulnar fracture]] | ||
|} | |} | ||
===Melone Classification=== | ===Melone Classification=== | ||
* Melone classified distal radius fracture based on Location | * Melone classified [[distal radius fracture]] based on Location | ||
{| class="wikitable" | {| class="wikitable" | ||
|+ | |+ | ||
| Line 49: | Line 49: | ||
|- | |- | ||
|I | |I | ||
| colspan="2" |Undisplaced, no or minimal comminution | | colspan="2" |Undisplaced, no or minimal [[comminution]] | ||
|- | |- | ||
| rowspan="3" |II | | rowspan="3" |II | ||
| colspan="2" |Die punch fracture with moderate to severe displacement | | colspan="2" |[[Die punch fracture]] with moderate to severe [[displacement]] | ||
|- | |- | ||
|A | |A | ||
| Line 67: | Line 67: | ||
|- | |- | ||
|V | |V | ||
| colspan="2" |Explosion fracture with severe comminution, transverse split and rotational displacement | | colspan="2" |Explosion fracture with severe [[comminution]], transverse split and rotational [[displacement]] | ||
|} | |} | ||
===Fernández Classification=== | ===Fernández Classification=== | ||
* Fernández classified distal radius fracture based on trauma mechanism | * Fernández classified [[distal radius fracture]] based on [[trauma]] mechanism | ||
{| class="wikitable" | {| class="wikitable" | ||
|+ | |+ | ||
| Line 77: | Line 77: | ||
|- | |- | ||
|Type 1 | |Type 1 | ||
|Bending fracture of metaphysis | |Bending [[Bone fracture|fracture]] of [[metaphysis]] | ||
|- | |- | ||
|Type 2 | |Type 2 | ||
|Shearing fracture of joint surface | |Shearing [[Bone fracture|fracture]] of joint surface | ||
|- | |- | ||
|Type 3 | |Type 3 | ||
|Compression fracture of joint surface | |Compression [[Bone fracture|fracture]] of joint surface | ||
|- | |- | ||
|Type 4 | |Type 4 | ||
|Avulsion fractures or radiocarpal fracture-dislocation | |Avulsion [[Bone fracture|fractures]] or [[radiocarpal]] [[fracture-dislocation]] | ||
|- | |- | ||
|Type 5 | |Type 5 | ||
|Combined fractures associated with high high-velocity injuries | |Combined [[Bone fracture|fractures]] associated with high high-velocity injuries | ||
|} | |} | ||
===Universal Classification=== | ===Universal Classification=== | ||
* Cooney classified distal radius fracture based on location | * Cooney classified [[distal radius fracture]] based on location and [[stability]] | ||
{| class="wikitable" | {| class="wikitable" | ||
|+ | |+ | ||
| Line 99: | Line 99: | ||
|- | |- | ||
|Type 1 | |Type 1 | ||
| colspan="2" |Extra-articular fracture, without deviation | | colspan="2" |Extra-articular [[Bone fracture|fracture]], without deviation | ||
|- | |- | ||
| rowspan="4" |Type 2 | | rowspan="4" |Type 2 | ||
| colspan="2" |Extra-articular fracture, with deviation | | colspan="2" |Extra-articular [[Bone fracture|fracture]], with deviation | ||
|- | |- | ||
|2A | |2A | ||
| Line 114: | Line 114: | ||
|- | |- | ||
|Type 3 | |Type 3 | ||
| colspan="2" |Intra-articular fracture, without deviation | | colspan="2" |Intra-articular [[Bone fracture|fracture]], without deviation | ||
|- | |- | ||
| rowspan="4" |Type 4 | | rowspan="4" |Type 4 | ||
| colspan="2" |Intra-articular fracture, with deviation | | colspan="2" |Intra-articular [[Bone fracture|fracture]], with deviation | ||
|- | |- | ||
|4A | |4A | ||
| Line 131: | Line 131: | ||
===OTA System=== | ===OTA System=== | ||
*AO/ASIF classification is the widely accepted classification | *AO/ASIF classification is the widely accepted classification | ||
*Radius is given the number 21 based on the classification | *[[Radius (bone)|Radius]] is given the number 21 based on the classification | ||
*It is further subdivided as: | *It is further subdivided as: | ||
{| class="wikitable" | {| class="wikitable" | ||
| Line 141: | Line 141: | ||
|- | |- | ||
|A1 | |A1 | ||
|Ulnar fracture, radius intact | |[[Ulnar fracture]], [[Radius (bone)|radius]] intact | ||
|- | |- | ||
|A2 | |A2 | ||
|Radius fracture, simple and impacted | |[[Radius fracture]], simple and impacted | ||
|- | |- | ||
|A3 | |A3 | ||
|Radius fracture, multifragmentary | |[[Radius fracture]], multifragmentary | ||
|- | |- | ||
| rowspan="4" |B | | rowspan="4" |B | ||
| Line 153: | Line 153: | ||
|- | |- | ||
|B1 | |B1 | ||
|Radius fracture, sagittal | |[[Radius fracture]], sagittal | ||
|- | |- | ||
|B2 | |B2 | ||
|Radius fracture, frontal, dorsal rim | |[[Radius fracture]], frontal, dorsal rim | ||
|- | |- | ||
|B3 | |B3 | ||
|Radius fracture, frontal, volar rim | |[[Radius fracture]], frontal, volar rim | ||
|- | |- | ||
| rowspan="4" |C | | rowspan="4" |C | ||
| Line 165: | Line 165: | ||
|- | |- | ||
|C1 | |C1 | ||
|Articular simple + | |Articular simple + [[metaphyseal]] simple | ||
|- | |- | ||
|C2 | |C2 | ||
|Articular simple, metaphyseal multifragmentary | |Articular simple, [[metaphyseal]] multifragmentary | ||
|- | |- | ||
|C3 | |C3 | ||
| Line 176: | Line 176: | ||
===Types of Fractures based on Eponyms=== | ===Types of Fractures based on Eponyms=== | ||
===Barton's Fracture=== | ===[[Barton's Fracture]]=== | ||
*Fracture-dislocation of radiocarpal joint (with intra-articular fracture involving the volar or dorsal lip) | *Fracture-dislocation of [[radiocarpal joint]] (with intra-articular fracture involving the volar or dorsal lip) | ||
===Chauffer's Fracture=== | ===[[Chauffer's Fracture]]=== | ||
*Fracture of radial styloid | *[[Bone fracture|Fracture]] of [[Radial styloid process|radial styloid]] | ||
===Colles'Fracture=== | ===[[Colles'Fracture]]=== | ||
*Dorsally displaced, extra-articular fracture | *Dorsally displaced, extra-articular [[Bone fracture|fracture]] | ||
===Die-punch Fracture=== | ===[[Die-punch Fracture]]=== | ||
* Depressed fracture of the lunate fossa (articular surface) | * Depressed [[Bone fracture|fracture]] of the [[lunate]] fossa (articular surface) | ||
===Smith's Fracture=== | ===[[Smith's Fracture]]=== | ||
*Volar displaced, extra-articular fracture | *Volar displaced, extra-articular [[Bone fracture|fracture]] | ||
==References== | ==References== | ||
Revision as of 01:57, 14 December 2018
|
Distal radius fracture Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Distal radius fracture classification On the Web |
|
American Roentgen Ray Society Images of Distal radius fracture classification |
|
Risk calculators and risk factors for Distal radius fracture classification |
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).[1][2][3][4][5][6]
Frykman Classification
- Frykman classified distal radius fracture based on Location
| 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
| 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
| 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
| 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
- 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.
- ↑ Fernandez DL (2001). "Distal radius fracture: the rationale of a classification". Chir Main. 20 (6): 411–25. PMID 11778328.
- ↑ Melone CP (1984). "Articular fractures of the distal radius". Orthop Clin North Am. 15 (2): 217–36. PMID 6728444.
- ↑ Melone CP (1993). "Distal radius fractures: patterns of articular fragmentation". Orthop Clin North Am. 24 (2): 239–53. PMID 8479722.
- ↑ 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.