Similarly, the mean interobserver agreement of the IDEAL classification was significantly higher than those of the AO and Frykman classifications and was similar to that of the Fernandez classification Table 5. The current classification systems for distal radial fractures are based on fracture morphology 11 Cooney WP. A modern treatment-based classification. Fractures of the distal radius: operative treatment. Instr Course Lect.
In the IDEAL classification, we aimed to provide data that would be relevant for treatment guidance and prognosis, by using five key elements: two epidemiological factors Age and trauma Energy and three radiographic factors Displacement, joint Incongruity, and associated Lesions.
An evidence-based rationale was used in order to develop this classification. When planning treatment, advanced patient age is one of the most important prognostic factors for instability, 25 Prediction of instability in distal radial fractures.
Assessment of instability factors in adult distal radius fractures. J Hand Surg Am. Open reduction and internal fixation of displaced, comminuted intra-articular fractures of the distal end of the radius. Acta Orthop Belg. Stability assessment of distal radius fractures. We believe that a combination of these factors can guide proper planning of treatment. IDEAL is a mnemonic that is easy to remember and categorizes fractures into three main types, numbered according to seriousness and requirement for stabilization, which makes it feasible to apply this classification in clinical practice.
Ilyas and Jupiter strengthened our classification rationale by stating that surgical indications can be placed into four categories: patient-related factors, fracture reduction, fracture stability and presence of associated injuries. A reliable distal radius fracture classification is necessary for systematic treatment of these fractures and is essential for comparing the results from different clinical studies.
Classification of distal radius fractures: an analysis of interobserver reliability and intraobserver reproducibility. Evaluation of simplified Frykman and AO classifications of fractures of the distal radius. Assessment of interobserver and intraobserver agreement. Int Orthop. In the present study, the intraobserver and interobserver reproducibility of the IDEAL classification was generally higher than that of the established classifications.
We believe that this classification system is more reliable because of clearness in assessing the classification features. The IDEAL classification system is easy to use and was reproducible, not only when used by the hand surgery specialist but also when used by the medical students. The AO and Frykman classifications, and to some extent the Fernandez classification, aim to be comprehensive in describing fractures.
However, the reliability of these systems is low, especially when subgroups are analyzed. In the present study, six evaluators with varying degrees of knowledge assessed radiographs according to the IDEAL system. They demonstrated that the level of expertise in evaluating fractures was not an important factor in relation to intraobserver reproducibility.
In addition, no marked improvement in intraobserver reproducibility was seen between the second and third assessments.
The IDEAL classification is reliable and shows good reproducibility in comparison with the existing classification systems. Prospective studies are needed in order to verify its clinical effectiveness in predicting instability, planning treatments and making prognoses for these fractures.
Abrir menu Brasil. Sao Paulo Medical Journal. Abrir menu. Felipe Vitiello Wink MD. About the authors. Colles' fracture; Classification; Wrist; Radius fractures; Reproducibility of results.
Table 1. IDEAL classification system: rationale and scoring. Table 2. Table 3. Intraobserver reproducibility T1, T2, T3 of the fracture classification. Table 4. Table 5. Pouteau C. Oeuvres posthumes de M. Paris: Ph. Pierres; Does an ulnar styloid fracture interfere with the results of a distal radius fracture? J Orthop Sci. Publication Dates Publication in this collection Ask each group of students to divide the animals based on whatever feature they choose.
Remind them to write down in their journals how they have grouped the animals. Ask students the following questions:. As you are probably aware, when you ask younger students to group animals, they may have a tendency to place each animal into its very own group. If this happens with your students, continue the exercise by asking them to search for common features between at least two animals, then at least between three animals. You can help students along by asking them to think about grouping the animals according to the following criteria:.
You can add pictures of other animals to this set of cards, as well as ask students to group them as many times as you see useful. Follow this lesson with the second lesson in the series on classification: Classification 2: A Touch of Class. The online unit of study called Living Things on the Franklin Institute website has a section called Families that can further your students' understanding about classification.
The classification of animals into groups helps broaden students' understanding about the diversity of life. To help emphasize the differences and similarities between species, you can refer your students to the Classifying Critters page of The Cool Science for Curious Kids website.
In this activity, students are given a chance to test their knowledge about different species. See the Tool. See the Collection. See the Lesson. Photo Credit: Science NetLinks. Did you find this resource helpful?
Other Lessons in This Series 1. Classification 1: Classification Scheme 2. Classification 2: A Touch of Class. From the order, the organism will be classified into a family. Within the order of primates, families include hominidae great apes and humans , cercopithecidae old world monkeys such as baboons and hylobatidae gibbons and lesser apes. Finally, the classification will come to the genus plural genera and species.
These are the names that are most commonly used to describe an organism. One outstanding feature of the Linnean classification system is that two names are generally sufficient to differentiate from one organism to the next. An example within the primate family is the genus Homo for all human species for example, Homo sapiens or Pongo for the genus of orangutan for example, Pongo abelii for the Sumatran orangutan or Pongo pygmaeus for the Bornean orangutan.
While this system of classification has existed for over years, it is constantly evolving. Classification in the s was based entirely on the morphological characteristics what something looks like of the organism. Those that looked most alike were put closest together in each category.
This can be depicted as a tree, with the diverging branches showing how different the species become as you move out from the kingdoms trunk.
Now, a radical shift in the grouping of organisms is occurring with the development of DNA technologies. Sequencing of the genetic code of an organism reveals a great deal of information about its similarity with and relationship to other organisms, and this classification often goes against the traditional morphological classification.
Scientists are debating which species are most closely related and why. Currently in New Zealand, there are projects to sequence kiwi and tuatara DNA that may revolutionise the way we think about these species and their closest living relatives. However, DNA technology is still expensive and time-consuming, so the first step in any classification continues to rely on a comparison of morphological features, similar to the process that Linnaeus undertook in the s.
Your students can learn more about how the Linnaean classification system works with this activity, Insect mihi. Classification is not a field that stays still and this means scientists and taxonomists sometimes have to reassess classifications.
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