Orthopaedics

What is a Barton Fracture?

Barton fracture

, first described by Dr. John Barton, is a fracture of the wrist. This fracture is a

distal radius fracture

 

which dislocates the

radiocarpal joint

 

. This fracture of the wrist is of two types, viz.

palmar and dorsal

 

. Palmar fracture is the more common form of this fracture and it is caused when a person fall when his/her wrist is fixed in the pronated (rotational forearm movement) position during the fall.

Understanding Barton Fracture:

In order to understand this fracture, it is first necessary to understand the anatomy of the human hand. The human hand consists of six kinds of bones (can be seen in the picture to the right), viz.

  • Hemurus
  • Ulna
  • Radius
  • Carpals
  • Metacarpals
  • Phalanges

The radiocarpal or the wrist joint is located between the radius and the carpal bones. The radius bone laterally extends into the wrist and thumb as well.

As already mentioned, a fracture to the radius bone leads to this fracture. The radiocarpal joint which is located between the radius and the carpal bones (according to the picture) is thus, dislocated in case the radius is fractured.

Differentiating with a Colles Fracture:

Radiographic imaging, often leads to a confusion while differentiating distal radius fractures in the hand.

  • The reason being, there is one more fracture called the Colles fracture which is also a distal radius fracture. This fracture also dislocated the wrist like in a palmar fracture. Thus, to differentiate between the two fractures, always the lateral area of the radius bone has to be checked.
  • In a palmar fractures’s case only the lateral side of the radius bone is damaged and the volar surface is remains unaffected.

Reverse Fracture:

Usually, a palmar fracture causes a dislocation in the lateral side of the radius bone. But, sometimes the distal radius’ volar can also be dislocated. This is called a reverse fracture.

This reverse fracture of the radius is often confused with Smith’s fracture which is actually a reverse of the Colles fracture.

People who suffer from a

Barton fracture

would have complications like tendon rupture, joint deformity and osteoarthritis. An internal fixation with the help of screws and plate has to done to heal the fracture.

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