PubMed · 7186016
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T J Flatley. 1982. Segmental spinal instrumentation.. https://doi.org/10.1080/01952307.1982.11735967
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We have assessed a number of ballistic fracture classifications but were unable to identify one that could adequately grade the severity of the injury, assist in determining the optimal treatment or predict outcome. Many of the existing classifications are based on experimental studies or radiological appearance and do not take into account the soft tissue injury, which is usually the main prognostic indicator. In addition few differentiated between different bones, and some were specific to only one bone. We would suggest that ballistic fractures are treated on an individual basis, specifically considering the soft tissue injury, the anatomical location of the injury and any involvement of joints. The specific weapon or muzzle velocity are not of prime importance, and classifications should not be based on these.
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Abraham Colles had the good fortune to describe the most common fracture about the wrist but, because its description was published in a provincial journal, it received little attention and was almost never referred to in his lifetime. The same can be said of Claude Pouteau who described the same fracture in another lesser-known medical journal. Robert Smith described the fracture that bears his name in 1847 although it had already been described by Jean-Gaspar-Blaise Goyrand some years before. Galeazzi's fracture had been described nearly 90 years earlier by Sir Astley Cooper and is also known as Dupuytren's and Piedmont fracture. To add to the conflicting nomenclature it is sometimes not clear whether a Smith's II fracture is a Barton's fracture or a reversed Barton's fracture. In the presence of all of this confusion it is not surprising that a Swiss group, Arbeitsgemeinschaft für Osteosynthesefragen, has classified wrist fractures into groups of As, Bs and Cs.