Background:Lunate subluxation in volar Barton (VB) distal radius fracture can complicate the treatment outcome. The aim of this study is to identify the computed tomographic (CT) predictors of lunate subluxation in VB fracture. Methods:This cross-sectional study was performed on VB fractures in two tertiary hospitals from March 2015 to March 2020. The CT scans were taken as close as possible to the neutral position of the limb within 24 h from the incidence of fracture. Joint involvement percentage, fragment dislocation, number of fragments, and lunate subluxation were collected from picture archiving and communication system. Calculations were performed using the pmsDview (Philips DICOM Viewer, R3.0 SP3, 2013) program. Results:A total of 41 patients (male/female ratio 4.85:1) with the mean age of 46 ± 17 years old were evaluated. The prevalence of lunate subluxation was 58.5%. Only the proximal volar segment displacement was significantly higher in lunate subluxation compared to non-subluxation group ([Formula: see text] = 0.001). Proximal volar segment displacement was significantly related to lunate subluxation (sensitivity and specificity were 75.0% and 70.1%, respectively, at cut-off point of 2.505). Conclusions:Proximal volar segment displacement would be the most important radiologic predictor for lunate subluxation in distal radius VB fractures.