Gartland & Werley classification

Gartland and Werley classification is a system used in the medical field to categorize the severity of distal radius fractures, which are common injuries affecting the wrist. This classification is instrumental in guiding the treatment plan and predicting the outcome for patients who have sustained such fractures. The Gartland and Werley score is based on radiographic findings, including the degree of displacement, comminution (the fracture breaks into several pieces), and involvement of the articular surface.

Classification

The Gartland and Werley classification divides distal radius fractures into three main types based on the severity and characteristics of the fracture:

• Type I: Nondisplaced fractures, where the bones are broken but remain in their normal anatomical position. These fractures typically require minimal intervention and have the best prognosis.

• Type II: Displaced fractures with some degree of bone fragment separation but without significant comminution. These fractures may require more complex treatment, including possible reduction (realignment of the fracture fragments) and immobilization.

• Type III: Severely displaced fractures with comminution and involvement of the articular surface. These fractures are the most challenging to treat and often require surgical intervention to restore the anatomy of the wrist as closely as possible.

Treatment

The treatment of distal radius fractures varies depending on the classification of the injury. Nonsurgical treatments, such as casting or splinting, are often sufficient for Type I fractures. In contrast, Type II and III fractures may require surgical intervention, including the use of pins, plates, and screws to stabilize the fracture fragments and facilitate healing.

Prognosis

The prognosis for patients with distal radius fractures depends on several factors, including the severity of the fracture as classified by the Gartland and Werley system, the patient's age, and the presence of any comorbid conditions. Generally, Type I fractures have an excellent prognosis with minimal long-term complications. Type II and III fractures, especially those involving the articular surface, may be associated with a higher risk of complications such as osteoarthritis, decreased wrist function, and chronic pain.

See Also

• Fracture
• Radius (bone)
• Wrist
• Osteoarthritis
• Orthopedic surgery