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“One consolation only remains, that the limb will, at some remote
period, enjoy perfect freedom in all its motion, and be completely
exempt from pain.
The deformity, however, will remain undiminished through life.”
Abraham Colles, 1814
Colles’ fracture
Prognostic significance of articular involvement pointed out by Gartland (1951)
Colles’ Fracture- A Colles’ fracture is defined as being a complete fracture within the distal inch of the radius with dorsal displacement of the distal fragment.
Specific fracture types• Colle's: Dorsal displacement (Abraham
Colles (1773-1843), Irish surgeon and anatomist)Smith's: Volar displacement (Robert William Smith (1807-1873), Irish surgeon)Barton's: Radial rim fracture with dislocation of the radiocarpal joint (can be dorsal or volar); John Rhea Barton (1794-1871) American surgeon.Chauffeur's: Radial styloid
• Backfire, Hutchison)
Eponymic descriptions—unhelpful
Colles Dorsal Barton
Chauffeur
Drivers injuredwhen turninga handle
Smith Palmar (reverse)Barton
Die-punch
Impaction bylunate (Sheck)
Distalsegment
Bone
-2 3
Type B Type A
Type A : Extraarticular
Type B : Partial articular
Type C : Complete articular
Type C
Müller AO Classification
Type AExtraarticular
Type BPartial articular
A1 A2 A3
B1 B3B2
sagittal frontalmultifrag.simple
rimpalmar (reverse-B))dorsal (Barton)
C1 C2
ulna radius
metaphysealsimple multifrag.
articular simple articular multifrag.
C3Type CComplete articular
Classifications for distal radius fractures
Watson – Jones:
• Closed (A)
• Open (B)
• Comminuted (C)
Classifications for distal radius fractures
Gartland & Werley,1951
• • Type I A Extra articular nondisplaced • • Type I B Extra articular displaced
(added by Solgaard & Sarmiento) • • Type II Intra articular nondisplaced • • Type III Intra articular displaced
Frykman's classification
• Ulnar styloid fracture • present absent • Extraarticular I II • ntraarticular • RC joint III IV • RU joint V VI • RC+RU VII VIII
Frykman’s classification
• Weakness No distinction between displaced & nondisplaced intraarticular fracture
• No mention of lateral view findings
Fernandez classification
• Based on mechanism of injury • • Bending • • Shearing • • Compression • • Avulsion • • High velocity
Universal classification evolved
• Based on simple concept and principle of extra articular versus intraarticular fracture and stable versus unstable fracture
Universal classification evolved
• Type I Non articular, Non displaced • Type II Non articular,displaced • A. Reducible, stable • B. Reducible, unstable • C.Irreducible
Universal classification evolved
• Type III Articular, undisplaced • Type IV Articular,displaced • A)Reducible,stable • B)Reducible,unstable • C) Irreducible• D)Complex
Malone's classification for intraarticular fractures
• Type I: Intrarticular undisplaced, minimal comminution
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