[An analytical classification of fractures of the distal radius: The "M.E.U." classification].
BACKGROUND
Fractures of the distal radius are often complex injuries involving to a varying degree the radial metaphysis (M), radial epiphysis (E) and distal ulna (U). The association of these three parameters varies in a given injury and each fracture is a specific lesion which often defies inclusion in a well-defined group. An analytical classification is proposed.


METHODS
The classification system analysed the three components of the fracture, assigning to each an index of gravity increasing from 0 to 4 and taking into account the main prognostic factor. Interobserver and intraobserver evaluation was carried out. The system was a posteriori applied to a prospective series of 166 distal radius fractures.


RESULTS
Mean interobserver reliability was 0.78 and mean intraobserver reproducibility 0.81. M and E were closely correlated with treatment, M with algodystrophy, E with pain and U with mobility and patient satisfaction at one year.


CONCLUSIONS
Inter- and intraobserver reproducibilities were good and the results validated our gravity indexes. This classification, describing all possible combinations of the three components of the fracture, is useful for both prognosis and treatment.
Laulan
J
J
Unité de chirurgie de la main, services d'orthopédie 1 et 2, CHU Trousseau, 37044 Tours, France. jacky.laulan@orange.fr
Bismuth
J-P
JP
Clément
P
P
Garaud
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003627:Data Interpretation, Statistical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011379:Prognosis; D011446:Prospective Studies; D011859:Radiography; D011885:Radius Fractures / Q000145:classification* / Q000000981:diagnostic imaging / Q000601:surgery; D012019:Reflex Sympathetic Dystrophy / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome