title: Adult distal radius fractures classification systems: essential clinical knowledge or abstract memory testing?
abstract: 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.
authors: Department of Trauma and Orthopaedic Surgery, Royal Shrewsbury Hospital , Shrewsbury UK.
authors: A
authors: A
authors: Shehovych
authors: Department of Trauma and Orthopaedic Surgery, Royal Shrewsbury Hospital , Shrewsbury UK.|Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry , Shropshire , UK.
authors: O
authors: O
authors: Salar
authors: Department of Trauma and Orthopaedic Surgery, Royal Shrewsbury Hospital , Shrewsbury UK.|Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry , Shropshire , UK.
authors: Cer
authors: C
authors: Meyer
authors: Department of Trauma and Orthopaedic Surgery, Royal Shrewsbury Hospital , Shrewsbury UK.|Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry , Shropshire , UK.
authors: D J
authors: DJ
authors: Ford
mesh_terms: D000328:Adult; D002983:Clinical Competence; D006801:Humans; D011885:Radius Fractures / Q000145:classification*; D015203:Reproducibility of Results
keywords: Classification systems; Distal radius; Fractures; Reliability; Reproducibility