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Bartons Fracture
From WikiSM
Contents
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
- Osteoporosis
- Male > Female
Differential Diagnosis
Distal Radius Fractures
- Barton's Fracture
- Chauffer's Fracture
- Colles' Fracture
- Die-Punch Fracture
- Radial Styloid Fracture
- Smith's Fracture
Differential Diagnosis Wrist Pain
- Fractures
- Dislocations
- Instability
- Tendinopathies
- Neuropathies
- Pediatric Considerations
- Distal Radial Epiphysitis (Gymnast's Wrist)
- Arthropathies
- Other
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
- Internal
- External
- Sports Medicine Review Wrist Pain: https://www.sportsmedreview.com/by-joint/wrist/
References
- ↑ 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.