The use of plain radiographs in the classification of distal radius fractures.

INTRODUCTION Classification systems guide surgical planning. We reviewed the accuracy of interpreting plain radiographs to classify distal radius fractures. METHODS Pre-operative radiographs of 24 consecutive distal radius fractures were classified using Frykman and AO methods. Classification was repeated intra-operatively under direct vision for comparison. RESULTS Mean age of the patients was 51 years. Pre-operative Frykman scores and AO grades were underestimated, compared with intra-operative visual classification (p < 0.001). One over-estimate occurred, while only 3 of 24 cases were classified correctly pre-operatively. CONCLUSION Sensitivity of radiographs to classify Frykman or AO grades was 12.5%, indicating interpretation using plain radiographs alone is often inadequate