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Barton’s fracture
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Barton’s fracture

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  • 1.  68 yo female presents after  T 97.6 P 98 BP 159/86 O2 slipping and falling while 97% getting out of the shower.  Gen: In obvious pain but Pt fell forward onto her NAD outstretched hand, with  MSK- obvious dorsal her wrist extended. Pt deformity/swelling to right complains of extreme pain wrist, limited range of in her left wrist, and denies motion in right wrist, 1+ hitting her head or any radial pulse other injuries.  Neuro- limited flexion/extension right wrist, nl sensation throughout
  • 2. Distal radius fracture w/ dislocation of radiocarpal joint
  • 3.  Pain Control Reduction of fracture, usually under conscious sedation Ortho consult needed, as non-op treatment usually fails Stability of reduction of dorsal Barton fx is best obtained with wrist extension to take advantage of intact volar carpal ligament
  • 4.  Most common fx dislocation of the wrist joint; - comminuted fx of distal radius may involve either anterior or posterior cortex and may extend into the wrist joint Fx dislocation or subluxation in which the rim of distal radius (dorsally or volarly) is displaced with the hand and carpus; - it often occurs along with a radial styloid frx - it differs from Colles or Smiths Fracture in that the dislocation is the most striking radiographic finding More common for distal fragment to be displaced dorsally, although it can dislplace volarly also (volar Barton’s fx)
  • 5.  http://www.wheelessonline.com/ortho/dorsal_barton s_fracture_dorsal_shearing_frx http://www.freebase.com/view/en/distal_radius_fract ure http://myradnotes.wordpress.com/2008/06/ http://www.radiologyassistant.nl/en/476a23436683b