# Distal Radius B Reducible Unstable->Ex fix/perc pins

C Irreducible-->ORIF pins/plate /Ex fix

FRYKMAN 1967 D Complex--> ORIF + graft plate/ex fix
# No Distal ulna# Distal Ulna#
Extra-artic I II UNSTABLE #;
------------------------------------------ >20 degrees dorsal angulation
Intra-artic + Marked dorsal comminution
Radiocarpal Jt III IV + Radial shortening of>10mm
Radioulnar Jt V VI
Radiocarpal + SECONDARY INSTABILITY
Radioulnar VII VIII Post MUA
Cast fails to maintain reduction and residual dorsal
Recognises imptance of DRUL angulation >10°
Doesn't recognise displaced vs undisplaced >5mm radial shortening

Melone 1984 X-RAY

Many intra-artic # not only had instabilty but also had Radial angulation avg 20° (16-28)
recognisable patterns of displacement--> Similar to Palmar tilt avg 14.5° (0-22)
Neer's for prox humerus Radial length avg 11-12mm
Usually 3-4 components Radial width/shift side to side diff <1mm
1. Shaft
2. Radial styloid POOR OUTCOME
3. Dorsal medial Extra-artic Abbaszdege 1991 267 pt
4. Palmar medial <20° dorsal tilt when radial shortening <5mm
Aro
Melone Radial shortening
Type I <3mm 90% G/E
-Undisplaced min comminution 3-5mm 25% G/E
Type II >5mm 31% G/E
-Lunate Fossa die punch;
--Ant displacement MALREDUCTION
--Post displacement Dorsal angulation alters wrist mechanics --> carpal
Type III collapse into flexion--> GET DISI pattern
-Radial shaft component & above With loss of UD ie radial shortening--> flexes scaphoid--
Type IV > inc scaholunate angle --> DISI
-Transverse split with rotation of artic fragments Shortening alone or in combination with angulation
disrupts congruency of DRUJ --> Pain, dec rotation,
COONEY 1990 Ulnar + hand and dec UD and RD
Type I
-Intra-artic undisplaced
Type II
-Displaced involving Radioscaphoid jt
Type III
-Displaced involving radiolunate jt
Type IV
-Displaced involving radioscaphoid, radiolunate and
sigmoid notch

UNIVERSAL CLASS
1990 Symposium conference

Type I
-Non-articular Non-Displaced
Rx cast immobilisation

Type II
Non-Artic Displaced
A Reducible, stable-----> POP
B Reducible unstable--->Perc pins
C Irreducible------------- >ORIF

Type III
Artic, Non-Displaced--> POP/Perc pins

Type IV
Artic Displaced
A Reducible stable-->MUA perc pins