Barton fracture

Clinical:

  • A 59 years old lady
  • Fall on outstretched left hand
  • Presented with pain at left wrist
  • Clinically deformed swelling of left wrist
  • “Piano sign” positive
  • Radial pulse palpable
Radiograph of left wrist in PA and lateral views

Radiographic findings:

  • There is comminuted fracture of distal radius (yellow arrows)
  • The fracture line involving the articular surface
  • There is dorsal displacement of dorsal rim and carpus
  • Fracture of ulnar styloid also seen (white arrow)
  • Distal radioulnar joint is preserved

CT scan findings:

  • There is a comminuted intra-articular fractures of the distal radius
  • The fractures mainly involve the posterior half of the distal radius.
  • Minimally displaced fracture fragments and intraarticular loose bodies are also seen, especially the radial aspect of the fracture.
  • Minimally displaced ulnar styloid fracture is also seen.
  • The radiocarpal joint is somewhat preserved.
  • No angulation of the distal part of radius is detected.
  • The Gilula’s arcs are preserved. No carpal bone fracture is detected.

Diagnosis: Dorsal type Barton fracture

Discussion:

  • Barton fracture is fracture of distal radius
  • In this case a dorsal type Barton fracture
  • The fracture line extends through the dorsal aspect of the articular surface but not to volar aspect
  • There is usually associated with dorsal subluxation or dislocation of radiocarpal joint

Progress of patient:

  • Open reduction and locked plating done

 

 

Author: radhianahassan