A new classification and its value evaluation for intermediate column fractures of the distal radius
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RESEARCH ARTICLE
Open Access
A new classification and its value evaluation for intermediate column fractures of the distal radius Ying Yang1†, Qudong Yin2†, Dongchen Li1, Yongjun Rui2, Yongwei Wu2, Yanping Ding1 and Yan Jiang1*
Abstract Background: Intermediate column fractures of the distal radius (ICF) are fractures only or mainly limited to the lunate fossa of the distal radius. There are no classification systems and its value evaluation for ICF in the literature. Methods: According to the characteristics of ICF, ICF were divided into the volar, dorsal, split, collapse, and collapse with split types. Inter- and intra-observer agreements were analyzed with kappa statistics. Seventy-four patients with ICF were retrospectively studied from January 2008 to June 2016. Surgical approach and reduction-fixation method were taken under the guidelines of the classification in 54 patients with displaced fractures, while conservative treatment was taken in 16 patients with non-obvious displaced fractures and 4 patients with displaced fractures who declined surgery. Results: The inter- and intra-observer kappa coefficients were 0.875~0.925 and 0.900~0.950, respectively. All patients were followed up for 13~36 months (average, 18.4 months). At the last follow-up, according to Gartland and Werley score of the functional recovery of wrist, all except 3 patients had excellent or good results (the excellent and good rate was 95.95%). Conclusion: The classification reflects the characteristics of ICF and may provide an important reference for choosing treatment and evaluating prognosis. Keywords: Distal radius fracture, Intermediate column, Classification
Background In 1996, Rikli and Regazzoni [1] presented the three-column theory of fractures of the distal radius, in which the ulnar half of the distal radius, composed of the lunate fossa and the sigmoid notch, was called the intermediate column. The intermediate column is the primary load-bearing and load transfer structure in the wrist, and it plays a key role in distal radius fractures [2–5]. Intermediate column fractures (ICF) of the distal radius are fractures only or mainly limited to the middle column of the distal radius that is a result of an axial load passed to the lunate fossa through the lunate. Some authors used the term die-punch fractures to refer to ICF [6–8]; however, the definition of die-punch fractures * Correspondence: [email protected] † Ying Yang and Qudong Yin contributed equally to this work. 1 Department of Radiology, Wuxi the Ninth People’s Hospital Affiliated to Suzhou University, Wuxi 214062, China Full list of author information is available at the end of the article
has been controversial [9–12], therefore which should be used as less as possible so as to avoid misunderstanding. To our knowledge, no previous study in literature has referred to classification and its value evaluation for ICF. The purpose of this study was to introduce a new classification for ICF and evaluate the value of the new classification.
Methods Classification sys
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