Distal radius fracture classification

Distal radius fracture Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Distal radius fracture from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
X Ray
CT
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Non-Operative Treatment
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Distal radius fracture classification On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Distal radius fracture classification All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Distal radius fracture classification
CDC on Distal radius fracture classification
Distal radius fracture classification in the news
Blogs on Distal radius fracture classification
Directions to Hospitals Treating Distal radius fracture
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: Vishnu Vardhan Serla M.B.B.S. [2]

Classification

In medicine, classifications systems are devised to describe patterns of injury which will behave in predictable ways, to distinguish between conditions which have different outcomes or which need different treatments. Most wrist fracture systems have failed to accomplish any of these goals and there is no consensus about the most useful one.

OTA System

The Trauma Association classification is widely accepted and under constant review. (More details available here.)

• (21-A) Extra-articular
  • (21-A2) Radius only
  • (21-A3) Radius and ulna
• (21-B) Articular fracture involving articular surface of only one of the two bones
  • (21-B2) Radius fractured, ulna intact
  • (21-B3) Articular of one bone, extra-articular of other
• ((21-C) Articular fracture involving articular surface of two bones
  • (21-C2) Simple of one, multifragmentary of other
  • (21-C3) Multifragmentary of both

Details on further levels of subcoding are available here (warning: PDF).

Other Systems

The images from this system illustrate how varied the injury can be. Wheeless details several classification systems, but comments "the classification does not include extent or direction of initial displacement, dorsal comminution, or shortening of the distal fragment; - hence, it is less useful in evaluating the outcome of treatment". These systems include:

• Frykman
• Melone
• Universal. Universal codes include:
  • Type I: extra articular, undisplaced;
  • Type II: extra articular, displaced;
  • Type III intra articular, undisplaced;
  • Type IV: intra articular, displaced;

General Features

Although there is no formal scientific classification based on them, there are three features of the fracture that relate to outcome and to each other:

• stability of the fracture
• displacement (especially of the joint surface)
• how severe the injury to the joint is

At one extreme a stable, undisplaced extra-articular fracture has an excellent prognosis. On the other an unstable, displaced intra-articular fracture is difficult to treat and has a poor prognosis.