Distal radius fracture classification: Difference between revisions
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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. | 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 | ===OTA System=== | ||
The [http://www.ota.org/compendium/radius.pdf|Orthopaedic Trauma Association classification] is widely accepted and under constant review. (More details available [[Bone fracture#OTA classification (Orthopaedic Trauma Association)|here]].) | The [http://www.ota.org/compendium/radius.pdf|Orthopaedic Trauma Association classification] is widely accepted and under constant review. (More details available [[Bone fracture#OTA classification (Orthopaedic Trauma Association)|here]].) | ||
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Details on further levels of subcoding are available [http://www.ota.org/compendium/radius.pdf here] (warning: PDF). | Details on further levels of subcoding are available [http://www.ota.org/compendium/radius.pdf here] (warning: PDF). | ||
===Other | ===Other Systems=== | ||
The images from this system illustrate how varied the injury can be. [http://www.wheelessonline.com/ortho/fractures_of_the_radius 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: | The images from this system illustrate how varied the injury can be. [http://www.wheelessonline.com/ortho/fractures_of_the_radius 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: | ||
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** Type IV: intra articular, displaced; | ** Type IV: intra articular, displaced; | ||
===General | ===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: | 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 | * stability of the fracture | ||
Revision as of 14:12, 15 March 2013
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Distal radius fracture Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Distal radius fracture classification On the Web |
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American Roentgen Ray Society Images of Distal radius fracture classification |
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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.