Distal Radius Fracture Melone Classification - Everything You Need To Know - Dr. Nabil Ebraheim

Video Description

Dr. Ebraheim’s educational animated video describes the Melone Classification of distal radius wrist fractures, the signs and symptoms, diagnostic tests, the prognosis and etiology, and the treatment options.
Highlight points about distal radius fractures:
1- The fracture being extra- or intra- articular: the intra-articular fractures are usually worse than the extra- articular fractures.
Fracture of the distal radius has many types and classifications:
• Fernandes.
• Frykman.
• Melone.
• Three Column Theory.
• AO.
- Each type will require a specific management and not all of them can be treated with a cast.
I use the Melone classification of distal radius fractures.
There are five types of intra- articular fractures divided into fracture types based on the displacement of the fracture and based on a consistent mechanism which is the lunate’s impaction injury.
The types are as follows:
• Type I: stable fracture without displacement, which result in four fragments:
1- Radial shaft fragment proximal to the fracture.
2- Radial styloid fragment.
3- Dorsal fragment of the lunate facet.
4- Palmar fragment of the lunate facet.
• Type II: unstable die punch displaced intra-articular fracture.
- Type II A: reducible.
- Type II B: is irreducible, usually treated with ORIF by surgery.
• Type III: spike fracture
- It’s a die punch fracture, unstable displaced, and also you have a spike from the radius, usually that spike will project into the flexor compartment and may involve the median nerve.
- The treatment is usually surgery to remove the spike and to fix the fracture.
• Type IV: split fracture
- Unstable medial complex that is severely comminuted with separation and/or rotation of the dorsal and palmar fragments.
- This fracture will need ORIF.
• Type V: explosion injury:
- Severe comminution and major soft tissue injury.



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