Classifying fractures of the distal radius: impossible or unnecessary? Review of the literature and proposal of a grouping system.

Reviewing the literature it was found that no classification of fractures of the distal radius is universally accepted regarding reproducibility, treatment orientation, and ability to predict outcome. The authors find the use of the existing classifications extremely difficult in practice, especially when trying to communicate, and believe that classification, treatment, and prognosis cannot be directly connected because of the complexity of fracture patterns and treatment options. Five hundred fractures of the distal radius were studied and a grouping system was developed in which fractures are positioned according to the direction of displacement of the distal part and the existence of an intra-articular extension. Nine special parameters are also defined that characterize the personality of each fracture of the distal radius. According to this personality, a fracture can be finally connected to treatment, which is presented in a special protocol also developed after a wide review of the literature. An easily reproduced and remembered grouping system of fractures of the distal radius is offered. This, when combined with the special parameters, leads to a complete description of the fracture and is directly connected to the treatment guidelines presented here as a special protocol.