Open Reduction and Internal Fixation with a Small T-plate for Volar Barton Fracture Management

Abstract

Background: One-sixth of all fractures in the emergency room are distal radius fractures. It is very important to recognize and adequately treat volar Barton fractures to avoid complication of malunion and its adverse effects. Although various fixation techniques have been described, with the plate, the patient can begin early active wrist workouts performing stable reduction.

Objective: Open reduction and small T-plate internal fixation of a distal radius volar Barton fracture were used to evaluate the functional outcomes for the fracture treatment.

Patients and Methods: At Zagazig University Hospital, 30 patients with a volar Barton fracture were studied in prospective interventional research, the study was carried out through six months. Preoperative X-ray and CT were done and the patient was prepared for surgery. By adopting an FCR technique (flexor carpi radialis approach), the fracture was reduced, the plate was fixed, and the image intensification was utilized for confirming the results.

Results: Mean operative time was 54.1±8.47 and of 30 patients operated upon, 16 patients were discharged one day after operation while the mean time lapse before surgery was 1.3±0.53. The mean time of bone union was 6.5±0.89 weeks (range 5-8 weeks). There was a significant improvement in wrist range of motion in all directions postoperatively. 2 patients (6.7%) had superficial infection, 1 patient (3.3%) had tourniquet paralysis, 1 patient had stiffness (3.3%) and another had mal-united fracture (3.3%).

Conclusion: Volar distal buttressing with the Ellis T plate is easy and inexpensive, and it delivers good functional benefits. Simplistic and low-complication procedure provides precise anatomical reduction of the fracture and restoration of the wrist's shape and function.