Volar Radiocarpal Fracture-Dislocation (Volar Barton’s Fracture)

Abstract

In 1837, John Rhea Barton of Philadelphia described both the dorsal and volar (Fig. 35-1) radiocarpal fracture-dislocations. Thomas later included the volar radiocarpal fracture- dislocation in his classification of Smith's fractures as a Smith Type II injury. This fracture can be very unstable and intraarticular and often must be fixed to achieve optimal stability and restoration of joint congruity. If the fracture associated with this carpal dislocation is a single or major fragment, it may be secured with lag screws (Fig. 35-2 A Fig. 35-2 C-F). Insertion of a T-plate or two one-quarter semitubular plates is also an excellent method of firmly securing an anatomic reduction of this fracture (Figs. 35-3 A-J and 35-4 A-L).