- Components: Shaft, Radial Styloid, and Dorsal Medial and Palmar Medial Parts;
- Type I:
-
colles frx equiv: undisplaced and minimally comminuted;
- Type II:
- die punch frx: unstable w/ moderate to severe displacement;
- similar to Mayo class II: displaced frx involving radioscaphoid joint;
- radioscaphoid joint frx: involves more than radial styloid (
Chauffeur frx)
fracture) and has significant dorsal angulation and radial shortening;
- requires stabilization provided by
external fixators, along w/
percutaneous pins, to maintain an accurate reduction;
- Type IIb (irreducible)
- this is a
double die punch frx which is an irreducible injury;
- dorsal medial component fragmentation;
- persistent radiocarpal incongruity > than 2 mm;
- radial shortening > 3 - 5 mm;
- dorsal tilting & displacement > of 10 deg
- radiocarpal step off > 5 mm (on a lateral view);
- requires open treatment for restoration of articular congruity;
- requires
ORIF of radiocarpal articular surface, supplementary
external fixation,
and iliac bone grafting;
- Type III:
- is die punch or lunate load fracture, and is often irreducible by traction alone;
- involves additional frx from shaft of radius that projects into flexor compartment;
- Mayo equivolent: are displaced involving the radiolunate joint;
- this may require fixation w/ small screws or wires
in conjunction with closed or
limited open articular surgery;
- Type IV:
- transverse split of articular surfaces w/ rotational displacement;
- Mayo eqivolent is a displaced frx involving both radioscaphoid & lunate joints,
and the sigmoid fossa of the distal radius;
- is often a more comminuted frx involving all of major joint articular surfaces,
& almost always includes frx component into distal
radioulnar joint;
--------------------------------------------
Intra-articular fractures of the distal end of the radius in young adults.
Distal Radius Fractures: Patterns of articular fragmentation.
CP Melone Jr.
Orthop Clin North Am. Vol 24, 1993. p 239-253.
