2. 68 yo female presents after
slipping and falling while
getting out of the shower.
Pt fell forward onto her
outstretched hand, with
her wrist extended. Pt
complains of extreme pain
in her left wrist, and denies
hitting her head or any
other injuries.
T 97.6 P 98 BP 159/86 O2
97%
Gen: In obvious pain but
NAD
MSK- obvious dorsal
deformity/swelling to right
wrist, limited range of
motion in right wrist, 1+
radial pulse
Neuro- limited
flexion/extension right
wrist, nl sensation
throughout
5. 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
6. 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 Smith's 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)