Wrist Fracture Classification - Andrew Bucknill - 1/5/2003

1 and 2

Extra-articular fracture ± distal ulna fracture

3 and 4

Intra-articular fracture involving the radiocarpal joint ± distal ulna fracture

5 and 6

Intra-articular fracture involving the DRUJ ± distal ulna fracture

7 and 8

Intra-articular fracture involving the RC and DRUJ ± distal ulna fracture

Group

1

2 parts: Barton #, Chauffeur #, Die-punch #

2

3 parts lunate and scaphoid fossae separate from distal radius

3

4 parts " like 3 part but with lunate fossa fractured into dorsal and volar fragments

4

5 parts or more

1

Minimal comminution - stable

2

Die-punch. Comminuted " unstable, dorsal or volar. 2a reducible, 2b irreducible

3

Spike. Displacement of medial complex as a unit + volar spike

4

Split . Wide separation or rotation of the dorsal fragment + palmar fragment rotation

5

Explosion fracture; severe comminution with major soft tissue injury

Type

1

No comminution on x-ray

2

Comminution of the dorsal radial cortex without comminution of the # fragment

3

Comminution of the # fragment without significant involvement of the dorsal cortex

4

Comminution of both the distal fragment and the dorsal cortex

1

Length of radial styloid >7 mm, dorsal angulation <5'

2

Length of radial styloid 1-7mm, dorsal angulation >5'

3

Length of radial styloid <4 mm, dorsal angulation >5'. Slight dorsal comminution

4

Length of radial styloid usually negative, dorsal angulation >5', comminution and often intra-articular

1

Simple extra-articular Colles #

2

Comminuted Colles # with undisplaced joint involvement

3

Comminuted Colles # with displaced joint involvement