Barton's fracture: Difference between revisions
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==Background== | ==Background== | ||
* | *Fracture-dislocation of distal radius extending into radiocarpal joint | ||
* | *Two types: volar and dorsal (based on direction of dislocation) | ||
==Imaging== | ==Clinical Features== | ||
*Wrist pain, usually after FOOSH injury | |||
==Differential Diagnosis== | |||
{{Distal radius fracture DDX}} | |||
==Evaluation== | |||
*Assess for distal pulse, motor, and sensation | |||
*Inspect skin for signs of open fracture | |||
===Imaging=== | |||
[[File:Radiograph_of_Barton's_fracture.jpg|thumb|Volar Barton's fracture]] | |||
*PA | *PA | ||
**Comminuted fracture of distal radial metaphysis | **Comminuted fracture of distal radial metaphysis | ||
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**Intra-articular fracture of volar or dorsal rim of radius | **Intra-articular fracture of volar or dorsal rim of radius | ||
== | ==Management== | ||
{{ | {{General Fracture Management}} | ||
== | ===Immobilization=== | ||
*Minimally displaced: [[sugar tong splint]] and ortho referral | *Minimally displaced: [[sugar tong splint]] and ortho referral | ||
==Disposition== | |||
*Can be managed as outpatient | |||
===Admit=== | |||
*[[Open fracture]] | |||
*Signs of neurovascular injury | |||
*Concern for [[compartment syndrome]] | |||
===Specialty Care=== | |||
*Unstable requires ORIF | *Unstable requires ORIF | ||
**>50% of radial articular surface | **>50% of radial articular surface | ||
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==See Also== | ==See Also== | ||
*[[Distal radius fractures]] | *[[Distal radius fractures]] | ||
*http://www.orthobullets.com/trauma/1027/distal-radius-fractures | |||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:Orthopedics]] | [[Category:Orthopedics]] | ||
Latest revision as of 04:29, 18 September 2019
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
- Colles' fracture
- Smith's fracture
- Barton's fracture
- Radial styloid fracture
- Distal radioulnar joint disruption
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
- PA
- Comminuted fracture of distal radial metaphysis
- Lateral
- Intra-articular fracture of volar or dorsal rim of radius
Management
General Fracture Management
- Acute pain management
- Open fractures require immediate IV antibiotics and urgent surgical washout
- Neurovascular compromise from fracture requires emergent reduction and/or orthopedic intervention
- Consider risk for compartment syndrome
Immobilization
- Minimally displaced: sugar tong splint and ortho referral
Disposition
- Can be managed as outpatient
Admit
- Open fracture
- Signs of neurovascular injury
- Concern for compartment syndrome
Specialty Care
- Unstable requires ORIF
- >50% of radial articular surface
- Accompanying carpal subluxation