Update on the consensus of classification systems in distal radius fracture
Keywords:
fracture classification, distal radius fracture, bone scan, digital traction.Abstract
Introduction: A classification is necessary for the correct orientation of the orthopedic surgeon in terms of differentiating the types of fractures at the distal end of the radius, their prognosis based on their complexity, the importance of radiography, the demographic variables of each case and what type of procedure will be the most suitable for the patient.Objective: To evaluate the current classifications for fractures of the distal end of the radius and to propose on the existing evidence which classification systems have better reliability and reproducibility.
Development: The Pubmed / MEDLINE, SciELO, BVS, Scopus, Ebsco and Cochrane databases were searched; the descriptors "distal radius fracture", distal radius fracture classification, wrist fracture were used. , consensus on fracture of the distal end of the radius, radiology in the fracture of the wrist, current therapeutic guidelines for the treatment of distal fractures of the radius, alone and with the following chains "classification", "radiology". 19 original articles, 10 review articles, 4 therapeutic guidelines, 2 research guides, and 2 specialty books were included. Classification systems for distal radius fractures were examined.
Conclusions: There is no consensus on the classification system. The poor contribution to the orthopedic of the Frykman classification is verified and that the AO system proves to be easier to interpret. The usefulness of skeletal traction radiography is evidenced for a useful diagnosis and to help the surgeon in making decisions for the treatment of the patient.
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References
1. Irisarri C, Freire C. Fracturas del extremo distal del radio: su perspectiva histórica. Acta Ortop Gallega. 2011 [acceso: 5/2/2020]; 7(2):61-67. Disponible en: https://sogacot.org/Documentos/V7N2.pdf
2. Shehovych A, Salar O, Meyer CER. and Ford DJ. Adult distal radius fractures classification systems: essential clinical knowledge or abstract memory testing? Ann R Coll Surg Engl. 2016 [acceso: 5/2/2020]; 98:525-531. DOI: 10.1308/rcsann.2016.0237.
3. Belloti JC, Gomes dos Santos JB, Picaro Erazo J, Iani LJ, Sugawara Tamaoki MJ, et al. A new method for classifying distal radius fracture: the IDEAL classification. Rev Bras Ortop. 2013 [acceso: 5/2/2020]; 48(1):36-40. Disponible en: https://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162013000100036
4. Pancorbo Sandoval EA, Martín Tirado JC, Delgado Quiñonez A y Henández Hernández J. Tratamiento de las fracturas del extremo distal del radio. Rev Cubana Ortop. 2005[acceso: 7/3/2020]; 19(2): [9 pantallas]. Disponible en: https://scielo.sld.cu/scielo.php?pid=S0864-215X2005000200012&script=sci_arttext&tlng=pt
5. Nascimento VG, Da Costa AC, Rodrigues da Silva I, Figueira Falcocchio D, Chakkour I, Checchia SL. Proposal Tomographic Classification for intra-articular distal radius fracture. Acta Ortop Bras. 2018 [acceso:7/2/2020]; 26(1):54-8. Disponible en: https://www.scielo.br/pdf/aob/v26n1/1413-7852-aob-26-01-00054.pdf
6. Kleinlugtenbelt YV, Groen SR, John Ham S, Kloen P, Haverlag R, Bhandari M, et al. Classification systems for distal radius fracture. Does the reliability improve using additional computed tomography? Acta Orthopaedica. 2017 [acceso: 7/2/2020]; 88(6):681-7. Disponible en: https://doi.org/10.1080/17453674.2017.1338066
7. Li D, Liu Y, Cheng Li D, Tang W, Yin Q. Identification of a novel three‑column classification for double‑column die‑punch fractures of the distal radius. Experimental and therapeutic medicine. 2020[acceso: 7/2/2020]; 19:1871-7. Disponible en: https://www.spandidos-publications.com/10.3892/etm.2020.8434
8. Etli I, Kozaci N, Avcib M, Faruk Karakoyun O. Comparison of the diagnostic accuracy of X-ray and computed tomography in patients with wrist injury. Injury. 2020 [acceso: 18/06/2020]; 51(3):651-5. Disponible en: https://doi.org/10.1016/j.injury.2020.01.034
9. Mulders MAM, Rikli D, Goslings JC, Schep N. Classification and treatment of distal radius fractures: a survey among orthopaedic trauma surgeons and residents. Eur J Trauma Emerg Surg. 2017[18/06/2020]; 43(2):239-48. Disponible en: https://pubmed.ncbi.nlm.nih.gov/26872680/
10. Kyriakedes JC, Tsai EI, Weinberg DS, Yu CC, Hoyen HA, Malone K, et al. Distal Radius Fractures: AAOS Appropriate Use Criteria Versus Actual Management at a Level I Trauma Center. Hand. 2018 [acceso: 7/2/2020]; 13(2): 209-14. Disponible en: https://pubmed.ncbi.nlm.nih.gov/28720040/
11. Jerrhag D, Englund M, Karlsson MK, Rosengren BE. Epidemiology and time trends of distal forearm fractures in adults-a study of 11.2 million person-years in Sweden. BMC Musculoskelet Disord. 2017 [acceso: 5/2/2020]; 18(240): [aprox. 8 pant.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5457562/
12. Solgaard S. Classification of distal radius fractures. Acta Orthop Scand. 1984 [acceso: 5/2/2020]; 56(3):249-52. Disponible en: https://doi.org/10.3109/17453678508993006
13. Kural C, Sungur I, Kaya I, Ugrar A, Erturk A, Cetinus El. Evaluation of the reliability of classification systems used for distal radius fractures. Orthopedics. 2010 [acceso: 5/2/2020]; 33(11):801. Disponible en: https://pubmed.ncbi.nlm.nih.gov/21053882/
14. Ilyas AM, Jupiter JB. Distal Radius Fractures-Classification of Treatment and Indications for Surgery. Orthop Clin N Am. 2007 [acceso: 5/3/2020]; 39(2):167-73. Disponible en: https://pubmed.ncbi.nlm.nih.gov/17560399/
15. Goncalves Machado, D, Auto da Cruz Cerqueira S, Fernandes de Lima A, Bezerra de Mathias M, Gabbi Aramburu JP, Ribeiro Pinho Rodarte R. Statistical analysis on the concordance of the radiological evaluation of fractures of the distal radius subjected to traction. Rev Bras Ortop. 2016 [acceso: 5/2/2020]; 51(1):11-15. Disponible en: https://dx.doi.org/10.1016/j.rboe.2014.12.010
16. Pancorbo Sandoval EA, Martín Tirado JC, Delgado Quiñónez A, Navarro Patou R, Díaz Piedra A y García García G. Tratamiento quirúrgico de las fracturas inestables del extremo distal del radio. Rev Cubana Ortop Traumatol. 2006 [acceso: 5/2/2020]; 20(2):[aprox. 8 pantallas]. Disponible en: https://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-215X2006000200002
17. Pancorbo Sandoval EA, Martín Tirado JC, Delgado Quiñónez A, Navarro Patou R, Quesada Pérez JA, Díaz Piedra A, et al. Comportamiento de la fractura del extremo distal del radio. Revista Médica Electrónica. 2007 [acceso: 2/4/2020]; 29(1): [aprox. 7 pant.]. Disponible en: https://www.cpimtz.sld.cu/revista%20medica/ano%202007/vol1%202007/tema01.htm
18. Micic I, Kholinne E, Sun Y, Kwak J, Jeon I. The Role of Additional K-Wires on AO Type C Distal Radius Fracture Treatment with External Fixator in Young Population. Advances in Orthopedics. 2019 [acceso: 7/2/2020]; 2019:8273018: [aprox. 6 pant.]. Disponible en: https://doi.org/10.1155/2019/8273018
19. Ploegmakers JJW, Mader K, Pennig D, Verheyen C. Four distal radial fracture classification systems tested amongst a large panel of Dutch trauma surgeons. Injury. 2007 [acceso: 5/2/2020]; 38(11):1268-72. Disponible en: https://www.researchgate.net/publication/6196014_
20. Serrano de la Cruz Fernández MJ. Fracturas distales de radio. Clasificación. Tratamiento conservador. Rev. Esp. de Cir. Osteoarticular. 2008 [acceso: 7/6/2020]; 46(236):141-54. Disponible en: https://www.cirugia-osteoarticular.org/adaptingsystem/intercambio/revistas/articulos/1855_141.pdf
21. Plant CE, Hickson C, Hedley H, Parsons NR, Costa ML. Is it time to revisit the AO classification of fractures of the distal radius? Inter- and intra-observer reliability of the AO classification. Bone Joint J. 2015 [acceso: 6/3/2020]; 97-B(6):818-23. Disponible en: https://pubmed.ncbi.nlm.nih.gov/26033063/
22. Putnam MD, Gustilo RB, Kyle RF, Templeman DC. Fracturas y Luxaciones. Tomo I. Madrid, España: Editorial Mosby/Doyma Libros; 1995.
23. Padegimas E, Ilyas AM. Distal Radius Fractures Emergency Department Evaluation and Management. Orthop Clin N Am. 2015 [acceso: 7/5/2020]; 46(2):259-70. Disponible en: https://dx.doi.org/10.1016/j.ocl.2014.11.010
24. Mulders MAM, Bentohami A, Beerekamp MSH, Vallinga J, Goslings JC, Schep NWL. Demographics, fracture patterns and treatment strategies following wrist trauma. Acta Orthop Belg. 2019 [acceso: 7/5/2020]; 85(2):234 -9. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31315015/
25. Testa G, Vescio A, Di Masi P, Bruno G, Sessa G, Pavone V. Comparison between Surgical and Conservative Treatment for Distal Radius Fractures in Patients over 65 Years. J. Funct. Morphol. Kinesiol. 2019[acceso: 7/5/2020]; 4(2):[aprox. 15 pant.]. Disponible en: https://www.mdpi.com/2411-5142/4/2/26
26. Rundgren J, Bojan A, Mellstrand Navarro C, Enocson A. Epidemiology, classification, treatment and mortality of distal radius fractures in adults: an observational study of 23,394 fractures from the national Swedish fracture register. BMC Musculoskeletal Disorders. 2020 [acceso: 7/2/2020]; 21(1):88. Disponible en: https://doi.org/10.1186/s12891-020-3097-8
27. Mulders MA, van Eerten PV, Goslings JC, Schep NWL. Non-operative treatment of displaced distal radius fractures leads to acceptable functional outcomes, however at the expense of 40 % subsequent surgeries. Orthop. Traumatol. Surg. Res. 2017 [acceso: 3/3/2020]; 103(6):905-9. Disponible en: https://dx.doi.org/10.1016/j.otsr.2017.01.017
28. Cole RJ, Bindra RR, Evanoff BA, Gilula LA, Yamaguchi K, Gelberman RH. Radiographic evaluation of osseous displacement following intra-articular fractures of the distal radius: reliability of plain radiography versus computed tomography. J Hand Surg Am. 1997 [acceso: 2/4/2020]; 22(5):792-800. Disponible en: https://europepmc.org/article/med/9330135
29. Delgado PJ, Martínez-Capoccini DM, Cervera J. Fracturas del radio distal: encuesta sobre preferencias de manejo y tratamiento. Rev Iberoam Cir Mano. 2015 [acceso: 7/4/2020]; 43(1):28-37. Disponible en: https://doi.org/10.1016/j.ricma.2015.06.006
30. He JJ, Blazar P. Management of High Energy Distal Radius Injuries. Curr Rev Musculoskelet Med. 2019 [acceso: 7/7/2020]; 12(3):379-85. Disponible en: https://doi.org/10.1007/s12178-019-09555-5
31. Sanhueza M, Azócar C, Lecaros JJ, Diaz C, Cifras JL. Fragmento dorso-ulnar en fracturas de radio distal: clasificación y manejo. Rev Chil Ortop Traumatol. 2018 [acceso: 17/9/2020]; 59(2):55-64. Disponible en: https://doi.org/10.1055/s-0038-1669430
32. Rhee PC, Medo RJ, Shin AY. Complex distal radius fractures: An anatomic algorithm for surgical management. J. Am. Acad. Orthop. Surg. 2017 [acceso: 18/6/2020]; 25(2):77-8. Disponible en: https://pubmed.ncbi.nlm.nih.gov/28033150/
33. Guideline Development Group. Best practice for management of Distal Radial Fractures (DRFs). UK: British Orthopaedic Association, British Society for Surgery of the Hand. 2018. [acceso: 7/7/2020]. Disponible en: https://www.bssh.ac.uk/_userfiles/pages/files/professionals/Radius/Blue%20Book%20DRF%20Final%20Document.pdf
34. Danish Health Authority. Treatment of distal radius fracture: National Clinical Guideline. Islands Brygge, Denmark; Sundhedsstyrelsen; 2017[acceso: 12/6/2020]; Disponible en: https://files.magicapp.org/guideline/6919c9d4-91a4-426c-a5d6-bc6a5802c37d/published_guideline_4800-0_5.pdf
35. American Academy of Orthopaedic Surgeons. Management of Distal Radius Fractures Evidence-Based Clinical Practice Guideline. Rosemont: American Academy of Orthopaedic Surgeons; 2020[acceso: 12/6/2020]. Disponible en: https://www.aaos.org/globalassets/quality-and-practice-resources/distal-radius/drfcpg.pdf
36. Danish Health Authority. National clinical guideline on the treatment of distal radial fractures. Copenhagen: Danish Health Authority; 2016 [acceso: 17/5/2020]. Disponible en: http://www.sst.dk/english Disponible en: https://www.sst.dk/-/media/Udgivelser/2016/NKR-H%C3%A5ndled-EN/EN_NKRHaandled2016.ashx?la=da&hash=36504CCDF7FA45A88C72025EE1DCE851A22A73D0
37. Álvarez Cambra R, Ceballos Mesa A, Murgadas Rodríguez R, Candebat Candebat R, Alemán López R, García Gutiérrez A, et al. Traumatología y Ortopedia. Tomo I. La Habana: Editorial Pueblo y Educación; 1985.
2. Shehovych A, Salar O, Meyer CER. and Ford DJ. Adult distal radius fractures classification systems: essential clinical knowledge or abstract memory testing? Ann R Coll Surg Engl. 2016 [acceso: 5/2/2020]; 98:525-531. DOI: 10.1308/rcsann.2016.0237.
3. Belloti JC, Gomes dos Santos JB, Picaro Erazo J, Iani LJ, Sugawara Tamaoki MJ, et al. A new method for classifying distal radius fracture: the IDEAL classification. Rev Bras Ortop. 2013 [acceso: 5/2/2020]; 48(1):36-40. Disponible en: https://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162013000100036
4. Pancorbo Sandoval EA, Martín Tirado JC, Delgado Quiñonez A y Henández Hernández J. Tratamiento de las fracturas del extremo distal del radio. Rev Cubana Ortop. 2005[acceso: 7/3/2020]; 19(2): [9 pantallas]. Disponible en: https://scielo.sld.cu/scielo.php?pid=S0864-215X2005000200012&script=sci_arttext&tlng=pt
5. Nascimento VG, Da Costa AC, Rodrigues da Silva I, Figueira Falcocchio D, Chakkour I, Checchia SL. Proposal Tomographic Classification for intra-articular distal radius fracture. Acta Ortop Bras. 2018 [acceso:7/2/2020]; 26(1):54-8. Disponible en: https://www.scielo.br/pdf/aob/v26n1/1413-7852-aob-26-01-00054.pdf
6. Kleinlugtenbelt YV, Groen SR, John Ham S, Kloen P, Haverlag R, Bhandari M, et al. Classification systems for distal radius fracture. Does the reliability improve using additional computed tomography? Acta Orthopaedica. 2017 [acceso: 7/2/2020]; 88(6):681-7. Disponible en: https://doi.org/10.1080/17453674.2017.1338066
7. Li D, Liu Y, Cheng Li D, Tang W, Yin Q. Identification of a novel three‑column classification for double‑column die‑punch fractures of the distal radius. Experimental and therapeutic medicine. 2020[acceso: 7/2/2020]; 19:1871-7. Disponible en: https://www.spandidos-publications.com/10.3892/etm.2020.8434
8. Etli I, Kozaci N, Avcib M, Faruk Karakoyun O. Comparison of the diagnostic accuracy of X-ray and computed tomography in patients with wrist injury. Injury. 2020 [acceso: 18/06/2020]; 51(3):651-5. Disponible en: https://doi.org/10.1016/j.injury.2020.01.034
9. Mulders MAM, Rikli D, Goslings JC, Schep N. Classification and treatment of distal radius fractures: a survey among orthopaedic trauma surgeons and residents. Eur J Trauma Emerg Surg. 2017[18/06/2020]; 43(2):239-48. Disponible en: https://pubmed.ncbi.nlm.nih.gov/26872680/
10. Kyriakedes JC, Tsai EI, Weinberg DS, Yu CC, Hoyen HA, Malone K, et al. Distal Radius Fractures: AAOS Appropriate Use Criteria Versus Actual Management at a Level I Trauma Center. Hand. 2018 [acceso: 7/2/2020]; 13(2): 209-14. Disponible en: https://pubmed.ncbi.nlm.nih.gov/28720040/
11. Jerrhag D, Englund M, Karlsson MK, Rosengren BE. Epidemiology and time trends of distal forearm fractures in adults-a study of 11.2 million person-years in Sweden. BMC Musculoskelet Disord. 2017 [acceso: 5/2/2020]; 18(240): [aprox. 8 pant.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5457562/
12. Solgaard S. Classification of distal radius fractures. Acta Orthop Scand. 1984 [acceso: 5/2/2020]; 56(3):249-52. Disponible en: https://doi.org/10.3109/17453678508993006
13. Kural C, Sungur I, Kaya I, Ugrar A, Erturk A, Cetinus El. Evaluation of the reliability of classification systems used for distal radius fractures. Orthopedics. 2010 [acceso: 5/2/2020]; 33(11):801. Disponible en: https://pubmed.ncbi.nlm.nih.gov/21053882/
14. Ilyas AM, Jupiter JB. Distal Radius Fractures-Classification of Treatment and Indications for Surgery. Orthop Clin N Am. 2007 [acceso: 5/3/2020]; 39(2):167-73. Disponible en: https://pubmed.ncbi.nlm.nih.gov/17560399/
15. Goncalves Machado, D, Auto da Cruz Cerqueira S, Fernandes de Lima A, Bezerra de Mathias M, Gabbi Aramburu JP, Ribeiro Pinho Rodarte R. Statistical analysis on the concordance of the radiological evaluation of fractures of the distal radius subjected to traction. Rev Bras Ortop. 2016 [acceso: 5/2/2020]; 51(1):11-15. Disponible en: https://dx.doi.org/10.1016/j.rboe.2014.12.010
16. Pancorbo Sandoval EA, Martín Tirado JC, Delgado Quiñónez A, Navarro Patou R, Díaz Piedra A y García García G. Tratamiento quirúrgico de las fracturas inestables del extremo distal del radio. Rev Cubana Ortop Traumatol. 2006 [acceso: 5/2/2020]; 20(2):[aprox. 8 pantallas]. Disponible en: https://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-215X2006000200002
17. Pancorbo Sandoval EA, Martín Tirado JC, Delgado Quiñónez A, Navarro Patou R, Quesada Pérez JA, Díaz Piedra A, et al. Comportamiento de la fractura del extremo distal del radio. Revista Médica Electrónica. 2007 [acceso: 2/4/2020]; 29(1): [aprox. 7 pant.]. Disponible en: https://www.cpimtz.sld.cu/revista%20medica/ano%202007/vol1%202007/tema01.htm
18. Micic I, Kholinne E, Sun Y, Kwak J, Jeon I. The Role of Additional K-Wires on AO Type C Distal Radius Fracture Treatment with External Fixator in Young Population. Advances in Orthopedics. 2019 [acceso: 7/2/2020]; 2019:8273018: [aprox. 6 pant.]. Disponible en: https://doi.org/10.1155/2019/8273018
19. Ploegmakers JJW, Mader K, Pennig D, Verheyen C. Four distal radial fracture classification systems tested amongst a large panel of Dutch trauma surgeons. Injury. 2007 [acceso: 5/2/2020]; 38(11):1268-72. Disponible en: https://www.researchgate.net/publication/6196014_
20. Serrano de la Cruz Fernández MJ. Fracturas distales de radio. Clasificación. Tratamiento conservador. Rev. Esp. de Cir. Osteoarticular. 2008 [acceso: 7/6/2020]; 46(236):141-54. Disponible en: https://www.cirugia-osteoarticular.org/adaptingsystem/intercambio/revistas/articulos/1855_141.pdf
21. Plant CE, Hickson C, Hedley H, Parsons NR, Costa ML. Is it time to revisit the AO classification of fractures of the distal radius? Inter- and intra-observer reliability of the AO classification. Bone Joint J. 2015 [acceso: 6/3/2020]; 97-B(6):818-23. Disponible en: https://pubmed.ncbi.nlm.nih.gov/26033063/
22. Putnam MD, Gustilo RB, Kyle RF, Templeman DC. Fracturas y Luxaciones. Tomo I. Madrid, España: Editorial Mosby/Doyma Libros; 1995.
23. Padegimas E, Ilyas AM. Distal Radius Fractures Emergency Department Evaluation and Management. Orthop Clin N Am. 2015 [acceso: 7/5/2020]; 46(2):259-70. Disponible en: https://dx.doi.org/10.1016/j.ocl.2014.11.010
24. Mulders MAM, Bentohami A, Beerekamp MSH, Vallinga J, Goslings JC, Schep NWL. Demographics, fracture patterns and treatment strategies following wrist trauma. Acta Orthop Belg. 2019 [acceso: 7/5/2020]; 85(2):234 -9. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31315015/
25. Testa G, Vescio A, Di Masi P, Bruno G, Sessa G, Pavone V. Comparison between Surgical and Conservative Treatment for Distal Radius Fractures in Patients over 65 Years. J. Funct. Morphol. Kinesiol. 2019[acceso: 7/5/2020]; 4(2):[aprox. 15 pant.]. Disponible en: https://www.mdpi.com/2411-5142/4/2/26
26. Rundgren J, Bojan A, Mellstrand Navarro C, Enocson A. Epidemiology, classification, treatment and mortality of distal radius fractures in adults: an observational study of 23,394 fractures from the national Swedish fracture register. BMC Musculoskeletal Disorders. 2020 [acceso: 7/2/2020]; 21(1):88. Disponible en: https://doi.org/10.1186/s12891-020-3097-8
27. Mulders MA, van Eerten PV, Goslings JC, Schep NWL. Non-operative treatment of displaced distal radius fractures leads to acceptable functional outcomes, however at the expense of 40 % subsequent surgeries. Orthop. Traumatol. Surg. Res. 2017 [acceso: 3/3/2020]; 103(6):905-9. Disponible en: https://dx.doi.org/10.1016/j.otsr.2017.01.017
28. Cole RJ, Bindra RR, Evanoff BA, Gilula LA, Yamaguchi K, Gelberman RH. Radiographic evaluation of osseous displacement following intra-articular fractures of the distal radius: reliability of plain radiography versus computed tomography. J Hand Surg Am. 1997 [acceso: 2/4/2020]; 22(5):792-800. Disponible en: https://europepmc.org/article/med/9330135
29. Delgado PJ, Martínez-Capoccini DM, Cervera J. Fracturas del radio distal: encuesta sobre preferencias de manejo y tratamiento. Rev Iberoam Cir Mano. 2015 [acceso: 7/4/2020]; 43(1):28-37. Disponible en: https://doi.org/10.1016/j.ricma.2015.06.006
30. He JJ, Blazar P. Management of High Energy Distal Radius Injuries. Curr Rev Musculoskelet Med. 2019 [acceso: 7/7/2020]; 12(3):379-85. Disponible en: https://doi.org/10.1007/s12178-019-09555-5
31. Sanhueza M, Azócar C, Lecaros JJ, Diaz C, Cifras JL. Fragmento dorso-ulnar en fracturas de radio distal: clasificación y manejo. Rev Chil Ortop Traumatol. 2018 [acceso: 17/9/2020]; 59(2):55-64. Disponible en: https://doi.org/10.1055/s-0038-1669430
32. Rhee PC, Medo RJ, Shin AY. Complex distal radius fractures: An anatomic algorithm for surgical management. J. Am. Acad. Orthop. Surg. 2017 [acceso: 18/6/2020]; 25(2):77-8. Disponible en: https://pubmed.ncbi.nlm.nih.gov/28033150/
33. Guideline Development Group. Best practice for management of Distal Radial Fractures (DRFs). UK: British Orthopaedic Association, British Society for Surgery of the Hand. 2018. [acceso: 7/7/2020]. Disponible en: https://www.bssh.ac.uk/_userfiles/pages/files/professionals/Radius/Blue%20Book%20DRF%20Final%20Document.pdf
34. Danish Health Authority. Treatment of distal radius fracture: National Clinical Guideline. Islands Brygge, Denmark; Sundhedsstyrelsen; 2017[acceso: 12/6/2020]; Disponible en: https://files.magicapp.org/guideline/6919c9d4-91a4-426c-a5d6-bc6a5802c37d/published_guideline_4800-0_5.pdf
35. American Academy of Orthopaedic Surgeons. Management of Distal Radius Fractures Evidence-Based Clinical Practice Guideline. Rosemont: American Academy of Orthopaedic Surgeons; 2020[acceso: 12/6/2020]. Disponible en: https://www.aaos.org/globalassets/quality-and-practice-resources/distal-radius/drfcpg.pdf
36. Danish Health Authority. National clinical guideline on the treatment of distal radial fractures. Copenhagen: Danish Health Authority; 2016 [acceso: 17/5/2020]. Disponible en: http://www.sst.dk/english Disponible en: https://www.sst.dk/-/media/Udgivelser/2016/NKR-H%C3%A5ndled-EN/EN_NKRHaandled2016.ashx?la=da&hash=36504CCDF7FA45A88C72025EE1DCE851A22A73D0
37. Álvarez Cambra R, Ceballos Mesa A, Murgadas Rodríguez R, Candebat Candebat R, Alemán López R, García Gutiérrez A, et al. Traumatología y Ortopedia. Tomo I. La Habana: Editorial Pueblo y Educación; 1985.
Published
2021-10-01
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Pancorbo Sandoval EA, Delgado Quiñones A, Díaz Prieto G. Update on the consensus of classification systems in distal radius fracture. Rev Cubana Med Milit [Internet]. 2021 Oct. 1 [cited 2025 Apr. 2];50(4):e02101016. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/1016
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