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Bartons Fracture

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Other Names

  • Barton Fracture
  • Dorsal Type Barton Fracture
  • Barton fracture-dislocation
  • Unstable Smith’s fracture
  • Volar Barton
  • Reverse Barton fracture

Background

  • Distal radius fracture extending through the dorsal aspect of the articular surface
    • Associated with radiocarpal joint dislocation
    • Articular surface of fractured distal radius
  • Named for Orthopedic surgeon John Rhea Barton

Pathophysiology

  • Fall on outstretched, pronated wrist resulting in a triagnular portion of radius being dorsally displaced along with carpus[1]
  • Anatomy: Distal Radius
  • Etiology
    • Young adults: Trauma (MVC, Sports)
    • Elderly: Fall from standing

Risk Factors


Differential Diagnosis

Distal Radius Fractures

Differential Diagnosis Wrist Pain


Clinical Features

  • General: Physical Exam Wrist
  • Wrist pain, swelling, bruising
  • Deformity possible depending on degree of injury

Evaluation

Radiology

CT

  • CT can be used to clarify fracture pattern or surgical planning

MRI

  • MRI for soft tissue injuries

Classification

  • N/A

Management

Nonoperative

  • Acute injury can be placed in sugar tongue splint
  • Most of these fractures require surgical management
  • If non-operative trial, cast with wrist palmar flexed

Operative

  • Surgical indications
    • Dorsal displacement >50% of lateral width of radius
    • Dorsal tilt > 20, fragment displaced > 1 cm
    • Radius shortening > 5 mm
    • Intra-articular disruption
    • Associated Ulna fracture
    • Carpal subluxation

Return to Play

  • Needs to be updated

Complications


See Also


References

  1. Harness N, Ring D, Jupiter JB. Volar Barton's fractures with concomitant dorsal fracture in older patients. J Hand Surg Am. 2004 May;29(3):439-45.
Created by:
John Kiel on 4 July 2019 06:59:55
Authors:
Last edited:
13 October 2022 21:38:31
Categories:
Trauma | Osteology | Wrist | Forearm | Upper Extremity | Fractures | Acute