Frykman Type 7-8 Distal Radius Fractures in Elderly Patients: Conservative Treatment vs Volar Plating.

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Abstract

Conflict of interest statement: Human subjects: Consent was obtained or waived by all participants in this study. Istanbul Medeniyet University Göztepe Training and Research Hospital Clinical Research Ethical Committee issued approval 2022/0543. This study was approved as a retrospective study by the Ethics Committee of Istanbul Medeniyet University Goztepe Training and Research Hospital. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. 2. Acta Orthop. 2017 Dec;88(6):681-687. doi: 10.1080/17453674.2017.1338066. Epub 2017 Jun 14. Classification systems for distal radius fractures. Kleinlugtenbelt YV(1)(2)(3), Groen SR(4), Ham SJ(1), Kloen P(5), Haverlag R(6), Simons MP(6), Scholtes VAB(1), Bhandari M(3), Goslings JC(7), Poolman RW(1). Author information: (1)a Department of Orthopaedic and Trauma Surgery , JointResearch Onze Lieve Vrouwe Gasthuis , Amsterdam. (2)b Department of Orthopaedic and Trauma Surgery , Deventer Ziekenhuis , Deventer. (3)f Division of Orthopaedic Surgery , McMaster University , Hamilton , Ontario , Canada. (4)c University of Amsterdam. (5)d Department of Orthopaedic and Trauma Surgery , Academic Medical Centre , Amsterdam. (6)e Department of General and Trauma Surgery , Onze Lieve Vrouwe Gasthuis , Amsterdam. (7)g Trauma Unit, Department of Surgery , Academic Medical Center, University of Amsterdam. Background and purpose - The reliability of conventional radiography when classifying distal radius fractures (DRF) is fair to moderate. We investigated whether reliability increases when additional computed tomography scans (CT) are used. Patients and methods - In this prospective study, we performed pre- and postreduction posterior-anterior and lateral radiographs of 51 patients presenting with a displaced DRF. The case was included when there was a (questionable) indication for surgical treatment and an additional CT was conducted within 5 days. 4 observers assessed the cases using the Frykman, Fernández, Universal, and AO classification systems. The first 2 assessments were performed using conventional radiography alone; the following 2 assessments were performed with an additional CT. We used the intraclass correlation coefficient (ICC) to evaluate reliability. The CT was used as a reference standard to determine the accuracy. Results - The intraobserver ICC for conventional radiography alone versus radiography and an additional CT was: Frykman 0.57 vs. 0.51; Fernández 0.53 vs. 0.66; Universal 0.57 vs. 0.64; AO 0.59 vs. 0.71. The interobserver ICC was: Frykman: 0.45 vs. 0.28; Fernández: 0.38 vs. 0.44; Universal: 0.32 vs. 0.43; AO: 0.46 vs. 0.40. Interpretation - The intraobserver reliability of the classification systems was fair but improved when an additional CT was used, except for the Frykman classification. The interobserver reliability ranged from poor to fair and did not improve when using an additional CT. Additional CT scanning has implications for the accuracy of scoring the fracture types, especially for simple fracture types. DOI: 10.1080/17453674.2017.1338066 PMCID: PMC5694815