Barton’s fracture
-
Upload
todd-peterson -
Category
Health & Medicine
-
view
1.935 -
download
1
Transcript of Barton’s fracture
Barton’s Fracture
History and Physical68 yo female presents
after slipping and falling while getting out of the shower. Pt fell forward onto her outstretched hand, with her wrist extended. Pt complains of extreme pain in her left wrist, and denies hitting her head or any other injuries.
T 97.6 P 98 BP 159/86 O2 97%
Gen: In obvious pain but NAD
MSK- obvious dorsal deformity/swelling to right wrist, limited range of motion in right wrist, 1+ radial pulse
Neuro- limited flexion/extension right wrist, nl sensation throughout
Radiographs
Diagnoses: Barton’s Fracture
Distal radius fracture w/ dislocation of radiocarpal joint
Pain ControlReduction of fracture, usually under
conscious sedationOrtho consult needed, as non-op treatment
usually failsStability of reduction of dorsal Barton fx is
best obtained with wrist extension to take advantage of intact volar carpal ligament
ED Management
Most common fx dislocation of the wrist joint; - comminuted fx of distal radius may involve either anterior or posterior cortex and may extend into the wrist joint
Fx 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 findingMore common for distal fragment to be displaced
dorsally, although it can dislplace volarly also (volar Barton’s fx)
Pearls
More Images
http://www.wheelessonline.com/ortho/dorsal_bartons_fracture_dorsal_shearing_frx
http://www.freebase.com/view/en/distal_radius_fracture
http://myradnotes.wordpress.com/2008/06/http://www.radiologyassistant.nl/en/
476a23436683b
References