Barton's fracture

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Background

  • Fracture-dislocation of distal radius extending into radiocarpal joint
  • Two types: volar and dorsal (based on direction of dislocation)

Clinical Features

  • Wrist pain, usually after FOOSH injury

Differential Diagnosis

Distal radius fractures

Distal radius fracture eponyms

Eponyms Description
Barton's Fracture-dislocation of radiocarpal joint (with intra-articular fracture involving the volar or dorsal lip)
Chauffer's Fracture of radial styloid
Colles' Dorsally displaced, extra-articular fracture
Die-punch Depressed fracture of the lunate fossa (articular surface)
Smith's Volar displaced, extra-articular fracture

Evaluation

  • Assess for distal pulse, motor, and sensation
  • Inspect skin for signs of open fracture

Imaging

Volar Barton's fracture
  • PA
    • Comminuted fracture of distal radial metaphysis
  • Lateral
    • Intra-articular fracture of volar or dorsal rim of radius

Management

  • Minimally displaced: sugar tong splint and ortho referral
  • Unstable requires ORIF
    • >50% of radial articular surface
    • Accompanying carpal subluxation

Disposition

  • Can be managed as outpatient

Admit

See Also

References