FRYKMAN CLASSIFICATION PDFJuly 10, 2020
4 observers assessed the cases using the Frykman, Fernández, Universal, and AO classification systems. The first 2 assessments were. Diagram shows the Frykman classification of distal radius fractures with or without involvement of the ulnar styloid: type I, simple metaphyseal area fracture; type. Frykman classification considers involvement of radiocarpal & RU joint, in addition to presnce or absence of frx of ulnar styloid process;.
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If you believe that this Physiopedia article is the primary source for the information you are refering to, you can use the button below to access a related citation statement. Original Editor – Stacy S Stone. The fracture originates from a fall on the outstretched hand and is usually associated with dorsal and radial displacement of the distal fragment, and disturbance of the radial-ulnar articulation.
Possibly the ulnar styliod may be fractured. Communication of the distal fragment and fractures into the joint surface are present in some of these fractures. The colles fracture is one of the most common and challenging of the outpatient fractures . Colles’ fracture is defined as a linear transverse fracture of the distal radius approximately mm proximal to the articular surface with dorsal angulation of the distal fragment .
The distal ulna attaches to a meniscus-like structure, the triangular fibrocartilage discus, which can be torn with wrist fractures. On the lateral side of the radius is a styloid process, onto which the brachioradialis inserts and from which the radial collateral ligament of the wrist originates. At the distal metaphysis of the radius, the cortex of the bone is thinner than the bone proximal and distal, and the relative amount of cancellous bone increases.
The distal metaphysis of the radius is therefore a relative weak point. This make fractures more likely, especially in patients with decreased bone mineral density.
Low energy extra-articular fracture of the distal radius. Can be associated with ulnar styloid fracture, TFCC tear, scapholunate dissociation. For further information on the Anatomy and assessment of the wrist. Females are predilected more than males for this type of injury and oftentimes there is a precedent history of osteoporosis.
It is known that these fractures appear mostly by young adults and the elderly . Stable Colles’ fractures present with minimal comminution. Unstable fractures are distinctly comminuted often with corresponding avulsions of the radial or ulnar styloid, that have the potential to cause compression neuropathies, especially of the median nerve.
Other complications that have been reported are degenerative joint disease and reflex sympathetic dystrophy . The relationship between Colles fractures and osteoporosis is strong enough that when an older male patient presents with a Colles fracture, he should classifidation investigated for osteoporosis because his risk of a hip fracture is also elevated.
Younger patients who sustain Colles fractures have usually been involved in high impact trauma or have fallen, e. Younger patients have stronger bone, and thus, more energy is required to create a fracture in these individuals. Motorcycle accidents, falls from a height, and similar situations are common causes of a DRF. Trauma is the leading cause of death in the to year-old frykmaan group, and this is also reflected in the incidence of lesser traumas.
Older patients have much weaker bones and can sustain a DRF from frykmqn falling on an outstretched hand in a ground-level fall. An increasing awareness of osteoporosis has led to these injuries being termed fragility fractures, with the implication that a workup for osteoporosis should be a standard part of treatment. As the population lives xlassification, the frequency of this type of fracture will increase. A distal fracture of the radius causes posterior displacement of the distal fragment, causing the forearm to be frylman posteriorly just proximal to the wrist.
If redisplacement of the Colles fracture is seen a few weeks after reduction, it’s important to take and check radiographs clasification week days after injury. Possible complications may include:. Few very rare complications are carpal tunnel syndrome, Sudeck’s atrophy and ulnar and radial compression neuropathy.
A careful history including the mechanism of injury establishes suspicion for a Colles fracture. Diagnosis is most often made upon interpretation of pasteroanterior and lateral views alone.
As Colles fractures are so common, many methods of treatment have been developed to stabilize the fractures and allow the bone to heal.
The ultimate goal is to return the vrykman to its prior level of functioning. Management of a Colle’s fracture depends on the severity of the fracture. An undisplaced fracture may be treated conservatively with a cast alone. Surgical options can include: The volar forearm splint is best for temporary immobilization of forearm, wrist and hand fractures, including Colles fracture.
The fracture pattern, degree of displacement, the stability of the fracture, and the age and physical demands of the patient will all be considered when determininmg the best treatment option  . Many patients will present to a physiotherapist with pain, edema, decreased range of motion, decreased strength, and decreased functional abilities.
The primary focus in early rehabilitation is to mobilize the wrist, which is indicated approximately weeks post fracture. This can predispose the patient to a contracture at the distal radioulnar joint. Frykmaan flexion and extension are often the first motions emphasized working within the patients pain free avaialble range.
The addition of ROM exercises helps to limit scar tissue and adhesion formation that commonly occur after surgery. It is also important to emphasise motion at the joint above and below shoulder, elbow, and fingers during all phases of rehab.
One of the classifkcation focuses in early rehab is to limit pain and the amount of oedema present in the wrist and hand region.
Classificaion fractures that were surgically treated, ROM should be regained between 6 to 8 weeks post-op. During strengthening, it is important to address all forearm muscles but also the extrinsic and intrinsic hand muscles progressively building classificayion as the individual gets stronger .
During this phase, progressive stretching can begin to increase available ROM. Each stretch should be held for seconds for 3 repetitions. If the patient is unable to tolerate a slow, prolonged stretch, shorter stretches of 10 seconds can be performed for 10 repetitions. Progress to strengthening of all joints .
ADL training within tolerance .
Frykman classification of distal radial fractures | Radiology Reference Article |
Cryotherapy is an effective modality for controlling edema in the acute phase after trauma and during rehab due its ability in helping to decrease blood flow through vasoconstriction limiting the amount of fluid escaping from capillaries to the interstitial fluid .
Cryotherapy can also be combined with compression and elevation in the treatment of oedema. The use of transcutaneous electrical nerve stimulation TENS may be used as an adjunct during any phase of rehab to address pain but can be particularly useful for patients that are increasing the level of activity of the wrist.
Conventional high-rate TENS is useful for disrupting the pain cycle through a prolonged treatment session as great as 24 hours a day. Low-rate TENS has been reported to be effective in pain control for up to hours post-treatment. The literature is still not conclusive on this topic and the results of one study may contradict or, on the contrary, reinforce the results lcassification another study. Yet there is evidence supporting the beneficial effects of electrical stimulation, especially classidication combination with physiotherapy exercises.
A case report used a rehabilitation protocol to improve range of motion and grip strength in an undisplaced, stable Colles’ fracture. The patient got a treatment with passive interventions to improve circulation and prevent immobilization adhesion formation. These treatments included application of an ice pack to reduce edema followed by application of a wax bath frukman the affected wrist. Gentle range of motion mobilizations were then introduced that could only be performed in flexion and classificarion to the patient’s pain tolerance.
The joint was also mobilized in circumduction, ulnar flexion and radial flexion to the patient’s level ffrykman tolerance. Early mobilisation resulted in rapid recovery of both vrykman and strength without causing more discomfort or adversely influencing the progression of the deformity. In patients over 55, minimally displaced fractures can safely be treated in a crepe bandage, and displaced fractures which have been reduced can be treated in a modified cast.
Early mobilisation would ensure rapid recovery of wrist and hand function while avoiding the complications of a conventional plaster cast . This study  proved that in the groups with displaced and undisplaced fractures, the classivication of forearm rotation and finger movement paralleled the recovery of wrist movement: Although this recovery did not parallel the improvement in wrist movement. In both categories early mobilization led to cllassification rapid resolution of wrist swelling in the first five weeks.
At nine weeks and at 13 weeks the wrist girths were similar. Patients encouraged to mobilise the injured wrist from the outset recovered wrist movement more quickly than those who were immobilized in a conventional plaster fryykman. The content on or accessible through Physiopedia is for informational purposes only.
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