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

1. Frykman

  • Descriptive only and does not include variables, such as direction and degree of displacement or comminution

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

2. McMurtry and Jupiter

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


3. Melone Classification

  • Sub-types of 4-part intra-articular fractures

  • Gives some indication to treatment

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

4. Universal Classification


5. AO

  • Comprehensive but has poor inter and intra observer agreement

 

6. Orthopaedic Trauma Association (OTA)

Based on AO classification


7. Jenkins

Based on comminution

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

8. Eponymous

      Colles

      Smiths

      Bartons

      Radial Styloid (Chauffeur's, Backfire, Hutchison)

9. Older

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

9. Gartland & Werley

1

Simple extra-articular Colles #

2

Comminuted Colles # with undisplaced joint involvement

3

Comminuted Colles # with displaced joint involvement

10. Sarmiento

11. Mayo


12. Mechanism of injury (Fernandez)

Bending (Colles, Smith)

Shear (Barton's, Radial Styloid)

Impaction (die-punch)

Avulsions with #-dislocation

Combination

13. Descriptive

Open / Closed



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