Dorsal double plate fixation of a distal radius fracture

Case contributed by Joachim Feger

Presentation

Wrist pain after a fall.

Patient Data

Age: 50 years
Gender: Female

Fragmentary fracture of the distal radius end segment.

The fracture extends into the articular surface.

The volar rim seems not involved.

CT confirms a fragmentary partial articular distal radius fracture of the dorsal rim.

Involvement of the distal radioulnar joint. Small intraarticular loose body.

Old fracture of the ulnar styloid. 

Impression:

Barton fracture - AO 2R3B2.2

Postoperative x-ray

x_ray

After open reduction and internal fixation with dorsal double plates.

Fragments and axis adjusted. Plates and screws are in a good, extra-articular position.

No significant articular steps are visible.

Unchanged position of the double dorsal plates and the screws. No signs of loosening.

No signs of malunion or nonunion.

Case Discussion

An example of a fragmentary partial articular of the radial dorsal rim or Barton fracture

Dorsal double plate fixation is seen in cases of comminuted dorsal articular fractures with involvement of the distal radioulnar joint or displaced dorsoulnar fragments. They are also used in complete articular multifragmentary fractures. 

They permit reduction and stabilization of the dorsal ulnar fragment and restore distal radioulnar joint anatomy. 

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