Open Reduction and Internal Fixation of Volar Barton's Fractures: A Prospective Study

Abstract

Purpose. To assess the functional and clinical outcomes of open reduction with internal fixation in the treatment of Barton's fracture of the wrist. Methods. From January 1997 to July 2003, a total of 19 cases of volar Barton's fracture were operated on by open reduction and internal fixation at the Nehru Hospital, Chandigarh, India. Records of 16 cases were available for study. Special care was taken during surgery to achieve articular congruity. The injury was caused by motor vehicle accidents in 13 cases and by a fall in 3. All cases were type-B3 fractures: 10 were of the B3.3 subtype, 4 of the B3.2 subtype, and 2 of the B3.1 subtype. Most (12) cases were operated on within one week of injury, 3 in one to 2 weeks, and one in 2 to 3 weeks. Results. All patients were assessed clinically and radiographically after a mean follow-up duration of 32.4 months (range, 12.0–65.0 months). Fractures healed after 7.0 to 10.0 weeks (mean, 8.8 weeks). Results of evaluations according to functional criteria were excellent in 9 cases, good in 5, and fair in 2. Radiocarpal osteoarthrosis developed secondary to trauma in 2 cases. There was no involvement of the median nerve in any of the 16 cases. Conclusion. Open reduction and internal fixation of volar Barton's fracture can restore articular congruity and result in good to excellent function.