Four distal radial fracture classification systems tested amongst a large panel of Dutch trauma surgeons

Ploegmakers, Joris J. W.; Mader, Konrad; Pennig, D.; Verheyen, Cees C. P. M.

doi:10.1016/j.injury.2007.03.032

Cited by 30 publications

(22 citation statements)

References 10 publications

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“…4 A reliable distal radius fracture classification is necessary for systematic treatment of these fractures and is essential for comparing the results from different clinical studies. 12,13,15,19,31,32 In the present study, the intraobserver and interobserver reproducibility of the IDEAL classification was generally higher than that of the established classifications. We believe that this classification system is more reliable because of clearness in assessing the classification features.…”

Section: Discussioncontrasting

confidence: 58%

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The IDEAL classification system: a new method for classifying fractures of the distal extremity of the radius description and reproducibility

et al. 2013

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The IDEAL classification system: a new method for classifying fractures of the distal extremity of the radiusdescription and reproducibility ABSTRACTCONTEXT AND OBJECTIVE: There is no consensus concerning which classification for distal radius fractures is best and the existing methods present poor reproducibility. This study aimed to describe and assess the reproducibility of the new IDEAL classification, and to compare it with widely used systems. DESIGN AND SETTING: Reproducibility study, Hand Surgery Section, Universidade Federal de São Paulo. METHODS:The IDEAL classification and its evidence-based rationale are presented. Sixty radiographs (posteroanterior and lateral) from patients with distal radius fractures were classified by six examiners: a hand surgery specialist, a hand surgery resident, an orthopedic generalist, an orthopedic resident and two medical students. Each of them independently assessed the radiographs at three different times. We compared the intra and interobserver concordance of the IDEAL, AO, Frykman and Fernandez classifications using Cohen's kappa (κ) (for two observers) and Fleiss's κ (for more than two observers). CONCLUSION:The reproducibility of the IDEAL classification was better than that of the other systems analyzed, thus making the IDEAL system suitable for application. Complementary studies will confirm whether this classification system makes adequate predictions for therapy and prognosis.

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Section: Discussioncontrasting

confidence: 58%

“…16,17 Currently, none of the classification systems available have reproducibility that adequately provides evidence for treatment and prognosis. 13,15,18,19 …”

Section: Introductionmentioning

confidence: 99%

The IDEAL classification system: a new method for classifying fractures of the distal extremity of the radius description and reproducibility

et al. 2013

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“…15 A more recent study showed poor agreement for reliability (not using kappa statistic) and only fair agreement for reproducibility with a kappa statistic of 0.27. 16 Frykman (1967) Frykman was one of the first to recognise the important of ulna styloid fractures. His classification system identifies the involvement of the radiocarpal and radioulnar joint, as well as the presence or absence of an ulna styloid fracture (Fig 4).…”

Section: Older's (1965)mentioning

confidence: 99%

“…19 Reliability and reproducibility worsens to fair to moderate when divisions within each type are considered. 7,16,19 Mayo (1992) In 1992, the Mayo Clinic proposed its own classification. It is a four-part classification similar to the Frykman classification in that is focuses on fracture extension into the radiocarpal or radioulnar (Fig 7).…”

Section: Ao/asif (1990)mentioning

confidence: 99%

Adult distal radius fractures classification systems: essential clinical knowledge or abstract memory testing?

Shehovych

Salar

Meyer

et al. 2016

annals

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Classification systems should be tools for concise communication, which ideally can predict prognosis and guide treatment. They should be relevant, reproducible, reliable, properly validated and most importantly simple to use and understand. There are 15 described distal radius classification systems present in the literature in the past 70 years, of which 8 are discussed in this paper. For each classification, we give an insight into its history, strengths and weaknesses, and provide evidence from the literature on reliability and reproducibility.Sadly, on completion of this paper we have not found a distal radius fracture classification that proved to be useful. Failings range from poor reproducibility and reliability, and over-complexity mainly emanating from the inability to classify this spectrum of injury in all of its manifestations. Consequently, we would suggest that classification systems for acute adult distal radius fractures are not useful clinical knowledge but mainly historical and/or research tools. Moreover, we would discourage trainees from spending time learning these classifications, as they serve not as essential clinical knowledge but more as forms of abstract memory testing.

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“…Examples are numerous. In two studies, a total of five classification systems of distal radius fractures were reviewed by Ploegmakers et al [48] and Belloti et al [49]. The interobserver agreement was unsatisfactory in all of them.…”

Section: Limitations and Flaws Of Current Fracture Classification Sysmentioning

confidence: 99%

Classification of Long Bone Fractures

Fleury

Stern

2014

European Surgical Orthopaedics and Traumatology

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Four distal radial fracture classification systems tested amongst a large panel of Dutch trauma surgeons

Cited by 30 publications

References 10 publications

The IDEAL classification system: a new method for classifying fractures of the distal extremity of the radius description and reproducibility

The IDEAL classification system: a new method for classifying fractures of the distal extremity of the radius description and reproducibility

Adult distal radius fractures classification systems: essential clinical knowledge or abstract memory testing?

Classification of Long Bone Fractures

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