Older, Stabler and Cassebaum classified Colles fractures based on the severity of the injury and the associated comminution. The authors are from Roosevelt Hospital in New York City.
|
Type |
Classification |
|
I |
nondisplaced |
|
II |
displaced with minimal comminution |
|
III |
displaced with moderate comminution of dorsal radius |
|
IV |
displaced with severe comminution of the radial head |
Parameters:
(1) angulation in dorsal and volar aspects
(2) shortening of radius (relative to distal end of the ulna)
(3) comminution of the dorsal and distal radius
|
Angulation |
Shortening |
Comminution |
Type |
|
loss of some volar angulation; up to 5° of dorsal angulation |
none (>= 2 mm above distal ulna) |
none |
I |
|
loss of volar angulation |
usually not below distal ulna; may be up to 3 mm below |
minimal |
II |
|
|
usually below distal ulna |
of dorsal radius; distal radial fragment with large pieces |
III |
|
|
2-8 mm below distal ulna |
marked of dorsal radius; marked of distal radius with shattering |
IV |
where:
• Volar refers to the flexor/palm surface of the wrist and forearm.
• Dorsal angulation increases with increasing comminution. This is best seen in the lateral X-rays of the wrist.
The outcome after healing tends to parallel the severity of the injury, with Type I injuries having excellent outcomes and Type IV injuries having some risk for poor outcome.
Specialty: Surgery, orthopedic, Emergency Medicine, Critical Care, Surgery, general
