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Dorsal Barton’s Fracture / Dorsal Shearing Frx

- Discussion:
    - distal radius fracture w/ dislocation of radiocarpal joint;
    - most common frx dislocation of the wrist joint;
    - comminuted frx of distal radius may involve either anterior or posterior cortex and may extend into the wrist joint;
           - frx dislocation or subluxation in which the rim of distal radius, dorsally or volarly is displaced with the hand and carpus;
    - it often occurs along with a radial styloid frx;
    - it differs from Colles' or Smith's Fracture in that the dislocation is the most striking radiographic finding;
           - in most cases, marginal frag is smaller than in anterior injury & often involves medial aspect where EPL crosses distal radius;

- Radiographs:

- Non Operative Treatment:
    - many of these frxs will fail nonoperative treatment;
    - manipulative reduction is same as for Colles Fracture;
    - stability of reduction of dorsal Barton frx is best obtained with wrist extension to take advantaage of intact volar carpal ligament;
    - immobilization for 6 weeks in short arm plaster cast;

- Operative Treatment:
    - is best treated by closed reduction, application of external fixation, followed by percutaneous pin insertion;
    - if reduction is not anatomic, fraying of the tendon at this level may to late rupture;
    - tendency to redisplace may require ORIF through dorsal approach
    - ref: Case-control study on T-shaped locking internal fixation and external fixation for the treatment of dorsal Barton's fracture

Anterior and posterior marginal fracture-dislocations of the distal radius. An analysis of the results of treatment.

Barton's fractures - reverse Barton's fractures. Confusing eponyms.

Barton's Fractures.