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. 2009 Sep;4(3):283-8.
doi: 10.1007/s11552-009-9163-1. Epub 2009 Jan 27.

The Buttazzoni classification of distal radial fractures in adults: interobserver and intraobserver reliability

Mats A Wadsten  1 , Arkan S Sayed-Noor, Göran O Sjödén, Olle Svensson, Gunnar G Buttazzoni
Affiliations

The Buttazzoni classification of distal radial fractures in adults: interobserver and intraobserver reliability

Mats A Wadsten et al. Hand (N Y). 2009 Sep.

Abstract

Despite the fact that distal radial fracture is the commonest fracture, there is a little evidence-based knowledge about the value of its classification to guide management and predict prognosis. The available classification systems are either complicated or weakly applicable in clinical practice. Older's classification is the most reliable, but does not cover all radial fracture types. We evaluated the interobserver and intraobserver reliability of a new classification system which is a modification of Older's classification covering all radial fracture types. Two hundred and thirty-two consecutive adult patients with acute distal radial fractures were blindly evaluated according to the new classification by three orthopedic surgeons twice with 1-year interval. The interobserver reliability was measured using the Fleiss kappa coefficient, and the intraobserver reliability was measured using the Cohen's kappa coefficient. The new classification showed fair to substantial interobserver and intraobserver reliability, i.e., results comparable to the reliability of commonly used classification systems. The reliability was better for younger patients and when evaluation was carried out by hand-surgery-interested orthopedic surgeons. The new classification system is simple, covers all radial fracture types, and has an acceptable reliability. Further studies are needed to judge its ability to direct management and predict prognosis.

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Figures

Figure 1
Figure 1
a Buttazzoni 1 DRF. Extraarticular with no cortical comminution. b Buttazzoni 2 DRF. Extraarticular with dorsal cortical comminution. c Buttazzoni 3 DRF. Intraarticular fracture with metaphyseal involvement. d Buttazzoni 4 DRF. Extraarticular with volar cortical comminution. e Buttazzoni 0 DRF. Fractures not classified elsewhere according to the new system belong to this type, e.g., partially articular fractures without metaphyseal involvement. Volar Barton is shown on the right and Chauffeur on the left.
See this image and copyright information in PMC

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