A classification and grading system for Barton fractures.

Abstract

We described a morphological classification and grading system for volar Barton fractures. We divided these fractures into four types: typical Barton, ulna Barton, radial Barton, comminuted Barton. Moreover, we graded the fractures into two degrees: simple split and split-depression. We retrospectively reviewed all wrist radiographs showing Barton fractures in our hospital between January 2013 and January 2015. We identified 100 cases whose records and radiographs were reviewed and included 36 men and 64 women with a mean age of 50years (15-78). The morphological classification was applied to the 100 cases by three reviewers on two occasions using the Kappa statistic. The inter- and intra-observer reliability of the morphological classification was 0.71-0.80 and 0.68-0.88, respectively. The distribution of typical, ulna, radial and comminuted Barton type fractures was 69%, 7%, 5% and 19%, respectively. Grade 2 fractures accounted for 49% in our series. This classification and grading system of Barton fractures is likely to have implications in terms of pathophysiology and surgical technique.