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 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
Distal radius fracture w/ dislocation of radiocarpal joint
 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
 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)
 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

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Barton’s fracture

  • 1.
  • 2.  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
  • 3.
  • 4. Distal radius fracture w/ dislocation of radiocarpal joint
  • 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)
  • 7.
  • 8.  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