Presentation
Patient presents to the ER with severe right wrist pain. Patient reports she lost balance while opening her car's trunk and fell onto concrete and her right hand.
Patient Data
There is an impacted comminuted intra-articular dorsally angulated fracture of the distal radius. Angulation estimated at 30 degrees. There is an avulsion fracture of the ulna styloid which is mildly displaced.
There is a comminuted fracture of the distal right radius. There has been improvement in overall dorsal angulation now estimated at 15 degrees previously 30 degrees. A detailed evaluation of the articular surface demonstrates that only the dorsal most margin of the radial articular surface is involved by an obliquely oriented fracture. Findings are consistent with a Barton fracture. The overall dorsal displacement measures approximately 0.2 cm.
The ulnar styloid demonstrates a comminuted fracture oriented both transversely as well as obliquely along its base. It is displaced by approximately 0.3 cm. The remainder of the ulna appears intact.
Evaluation of the carpus demonstrates no further evidence of acute osseous abnormality.
There are findings of chondrocalcinosis scattered throughout the proximal and distal carpal rows.
Case Discussion
CT findings were consistent with a Barton fracture with articular involvement isolated to the dorsal margin. Patient underwent open reduction and internal fixation with volar plate and screws.
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