Classifications in Brief: Fernandez Classification of Distal Radius Fractures

Abstract

AIM: Assess the scientific value and validity of the Fernandez classification to treat and study distal radius fractures.

METHODS: A review article evaluated current and past literature to determine the interobserver reliability of the Fernandez classification and its application in distal radius fractures. A literature review was performed using search engines including Pubmed.

RESULTS: The literature demonstrated kappa scores of initial distal radius fracture evaluation 0.39 and for a second look 3 months later to be 0.15. Intra-class correlations were 0.4 and 0.12 respectively demonstrating poor intra and interobserver reliability. Additionally, CT scans utilized after initial assessment via radiographs did not improve identification.

CONCLUSION: This classification has only moderate reliability that was not improved by the addition of CT scans. When this classification was specifically tested in the clinical setting, it showed no reliability when predicting associated soft tissue or structure injury. The Fernandez classification system intention was to provide a treatment algorithm, it does not serve much use outside of its historical context in the understanding of distal radius fractures.