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Upper limb trauma fracture classifications
Upper limb trauma classifications provide standardized systems for describing fractures and dislocations involving the clavicle, shoulder, humerus, elbow, forearm, wrist, hand, and fingers. They help define fracture location, displacement, comminution, articular involvement, stability, and associated soft-tissue injury, thereby assisting communication, prognosis, and treatment planning.
Upper limb trauma classifications encompass a wide range of systems used to categorize injuries from the shoulder girdle to the fingertips. Different classifications are designed to describe specific anatomical regions and injury patterns and are frequently used in orthopaedic examinations and clinical decision-making. Around the shoulder girdle, commonly used systems include the Allman and Neer classifications for clavicle fractures, Rockwood classification for acromioclavicular joint injuries, and Neer classification for proximal humerus fractures. Scapular injuries may be classified according to the anatomical part involved, with specific systems used for glenoid and acromial fractures. For the humeral shaft, fractures may be described by location and morphology, while distal humeral injuries include systems such as the Gartland classification for paediatric supracondylar fractures, Milch classification for lateral condyle fractures, and Bryan–Morrey classification for capitellar fractures. At the elbow and forearm, important systems include the Mason classification for radial head fractures, Regan–Morrey classification for coronoid fractures, Bado classification for Monteggia injuries, and classifications for olecranon and radial neck fractures. Forearm fractures may also be described according to level, displacement, and associated radioulnar joint disruption. At the wrist, distal radius fractures are classified using systems such as Frykman, Fernandez, Melone, and AO/OTA, while carpal injuries include classifications for scaphoid fractures, scaphoid non-union, perilunate injuries, and carpal instability. In the hand, classification systems are used for metacarpal, phalangeal, and intra-articular fractures as well as tendon avulsion injuries and fracture-dislocations. Examples include classifications for Bennett and Rolando fractures, mallet finger, volar plate injuries, and thumb MCP collateral ligament injuries. The purpose of these systems is to provide a reproducible description of injury severity, facilitate communication between clinicians, guide treatment, and estimate prognosis. However, no single classification is ideal for every injury, and clinical assessment, imaging, soft-tissue status, and patient factors must always be considered alongside the classification itself.
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