Prospective Descriptive Study of Radiological and Functional Outcomes of Volar Barton’s Fracture Fixed by Volar Locked Plate
DOI:
https://doi.org/10.3889/oamjms.2022.8615Keywords:
Volar Barton’s fracture, Volar locked buttress plate, Functional and anatomical evaluationAbstract
BACKGROUND: Volar Barton’s fracture is a shearing mechanism of injury that results in fracture and subluxation of distal end radius in which volar rim of the distal radius is displaced with hand and carpus. Open reduction and volar plate fixation ensure more stable change of displacement, preservation of reduction, and early mobilization.
AIM: This study aims to assess the functional and radiological outcome results of volar Barton’s fracture treated by volar buttress plate using the demerit points system of Gartland and Werley.
PATIENTS AND METHODS: This study is a prospective descriptive observational study on 32 patients who were treated with ORIF by volar buttress plate for isolated volar Barton’s fractures between February 2018 and June 2020 in Alkindy teaching hospital/Baghdad/Iraq. All volar Barton’s fracture cases satisfying the inclusion criteria which included patient over 18 years, isolated fracture, medically fit, and <5 days old injuries, while fractures extend to radius shaft, compound fractures, and associated with other injuries were excluded from the study. All fractures are fixed by volar locked plate followed up for 12 week’s duration for functional and radiological assessment using the Demerit points system of Gartland and Werley.
RESULTS: Most cases were in the age group below 40 years, average age 38 years (range 19–64 years), male patient was 69%, side of involvement was right wrist in 75% of cases, falling on an outstretched hand account 50%, while roads traffic accidents in 37.5%, fall from a height in 6.25%, and direct trauma in 6.25%. The final sequel of the results was average volar tilt was 11.1°, the radial shortening average was 4 mm, the radial inclination average was 19.9°, and the ulnar variance was 0.3 mm. Functional outcomes depending on Gartland and Werley’s score were 50% as excellent results, 43.75% as good results, 6.25% as fair results, and no poor results in this study.
CONCLUSIONS: Volar locking buttress plate provides fracture stability and early mobilization, therefore, recovery of daily live activity in a short time.Downloads
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References
Bloom A, Warwick D, Whitehouse MR. Apley and Solomon’s System of Orthopedics and Fractures. 10th ed. Milton Park, Abingdon-on-Thames: Taylor and Francis Group; 2018. p. 407-711.
Derek Moore. Wrist Trauma; 2019. Available from: https://www.orthobullets.com [Last accessed on 2019 Feb 25].
Azar FM, Beaty JH, Canale ST. Campbell’s Operative Orthopaedics. 13th ed. Maryland Heights, Missouri: MOSBY Elsevier; 2017. p. 2990-9.
Keith M, Agur A, Arthur D. Clinically Oriented Anatomy. 7th ed. Lippincott Williams and Wilkins; 2013. p. 446.
Zemel NP. The prevention and treatment of complications from fractures of distal radius and ulna. Hand Clin. 1987;3(1):1-11. PMid:3818803 DOI: https://doi.org/10.1016/S0749-0712(21)00630-2
Smithius R, van Delden O. Radiology Assistant Musculoskeletal System; 2019.
Westphalia T, Piatek S, Schubert S, Winckler S. Outcome after surgery of distal radius fracture: No difference between external fixation and ORIF. Arch Orthop Trauma Surg 2005;30:289-99. DOI: https://doi.org/10.1007/s00402-005-0023-3
Vasenius J. Operative treatment of distal radius fractures. Scand J Surg 2008;97:290-6. DOI: https://doi.org/10.1177/145749690809700403
Harness N, Ring D, Jupiter JB. Volar Barton’s fractures with a concomitant dorsal fracture in older patients. J Hand Surg Am. 2004;29(3):439-45. https://doi.org/10.1016/j.jhsa.2003.12.009 PMid:15140487 DOI: https://doi.org/10.1016/j.jhsa.2003.12.009
Kwok IH, Leung F, Yuen G. Assessing results after distal radius fracture treatment: A comparison of objective and subjective tools. Geriatr Orthop Surg Rehabil. 2011;2(4):155-60. https://doi.org/10.1177/2151458511422701 PMid:23569685 DOI: https://doi.org/10.1177/2151458511422701
Tang Z, Yang H, Chen K, Wang G, Zhu X, Qian Z, et al. Therapeutic effects of volar anatomical plates versus locking plates for volar Barton’s fractures. Orthopedics. 2012;35(8):e1198-203. https://doi.org/10.3928/01477447-20120725-19 PMid:22868605 DOI: https://doi.org/10.3928/01477447-20120725-19
Aggarwal AK, Nagi ON. Open reduction and internal fixation of volar Barton’s fractures: A prospective study. J Orthop Surg (Hong Kong). 2004;12:230-4. https://doi.org/10.1177/230949900401200218 PMid:15621913 DOI: https://doi.org/10.1177/230949900401200218
Bradway JK, Amarion PC, Cooney WP 3rd. Open reduction internal fixation of displaced comminuted intraarticular fracture of the distal end of the radius. J Bone Joint Surg. 1989;71A(6):839-47. PMid:2745480 DOI: https://doi.org/10.2106/00004623-198971060-00007
Jupiter JB, Fernandez DL. Comparative classification for fractures of the distal end of the radius. J Hand Surg Am. 1997;22(4):563-71. https://doi.org/10.1016/S0363-5023(97)80110-4 PMid:9260608 DOI: https://doi.org/10.1016/S0363-5023(97)80110-4
Madhukar, Srinivasan N, Pugazhendhi G, Vijayanarasimhan, Sivakumar A, Venkatachalam K. Functional outcome of volar Barton’s fracture treated with volar plate osteosynthesis. Sch Acad J Biosci. 2016;4(3B):237-43.
Bhattacharya P, Choudhury FA, Khanna A. Treatment outcome of locking comp ression plates in volar Barton’s fracture. Int J Med Phar Sci. 2015;5(5).
Sing S, Nelofar M, Dave JK. Prospective study of evaluations of functional outcome of volar Barton’s fractures of distal radius treated by volar plating. Int J Sci Res. 2018;7(6):439-44. https://doi.org/10.21275/ART20182922
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Copyright (c) 2022 Haider O. Hayat Ali Al-Faily, Hussein Ali Nasir, Thaer Rasim Mohammed, Mohammed Al-Edanni (Author)
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