Treatment of old Barton's fracture

Abstract

Objective To analyze the etiology of old Barton's fractures and discuss the diagnostis strategies and treatment options. Methods Sixteen cases of old Barton's fracture(11 cases of volar fractures and 5 cases of dorsal fractures) were involved.Plain X-ray examines were combined with CT scan to determine type of the fractures.displacement of ioint surfaces and the severity of wrist joint dislocation.Eleven cases of volar Barton's fractures were fixed with T-shaped metallic plate via a volar-radial approach.Five cases of dorsal Barton fractures were treated with limited intemal fixation combined with external fixator via a distal dorsolateral incision. Results All 16 patients were followed-up for 10 to 36 months postoperatively.Bone union was seen in all cases.The volar tilting angle was 10°～15°(average 11.3°).The ulnar inclining angle Was 16°～25°(average 20°).There was no shortening of the radius.According to Mehara's evaluation for volar Barton's fractures.15 cases(93.8%)had obtained sarisfying results(excellent in 13 cases.good in 2 cases,fare in 1 case). Conclusions Open reduction and intemal fixation is an effective method to treat old Barton's fractures.CT scan is helpful in revealing fracture details.displaying joint surface displacement,and judging the accuracy of surgical reduction and fixation. Key words: Fractures.bone; Fracture fixation; Treatment outcome