Frykman classification and Lafontaine criteria for distal radius fractures
The 8 Frykman stages and 5 Lafontaine criteria are shown.
Case Discussion
Fractures of the distal radius can be classified using the Frykman system. Although there are 8 different fracture types, the fracture patterns are easily remembered as follows: Type I has no intraarticular extension, type III extends into the radiocarpal joint, type V extends into the distal radioulnar joint, and type VII extends into both the radiocarpal and radioulnar joints. The even types are identical to the odd types with the addition of an ulnar styloid fracture.
The Frykman calssification is easy to learn, but has been criticized for being insufficiently predictive of instability. Lafontaine et. al. have proposed 5 criteria that when present are predictive of instability: 1) initial dorsal fracture angulation > 20 degrees, 2) dorsal comminution, 3) radiocarpal joint extension, 4) associated ulnar fracture, and 5) age > 60 years.
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