Distal Radial Fractures Classification

“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)

Classifications for distal radius fractures

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

• Type II: Lunate fossa, die-pinch fracture,

anterior and posterior displacement

• Type III: A radial shaft component in addition to previous findings

• Type IV: Transverse split fracture with rotation of articular surfaces

Mayo's classification

• Type I : Intraarticular, undisplaced • Type II :Involving scaphoid articular

surface • Type III : Lunate + sigmoid notch involved • Type IV : 2 or more articular surfaces.