Correlation between functional and radiological outcome after surgical stabilization of volar Barton fracture with plating: a comparative study
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20202050Keywords:
Volar Barton fracture, Plating, Functional outcome, Radiological outcomeAbstract
Background: The objective of the study was to evaluate the functional and radiological outcomes after open reduction with internal fixation of volar Barton’s fracture of the wrist and compare their outcomes.
Methods: Total of 30 cases of volar Barton fractures were operated by open reduction and internal fixation with plating. Mean follow up period was 6 months. Patients were assessed both radiological and functional outcome and compare between the two outcomes.
Results: All fractures were healed in a mean period of 7 weeks (range 6-9 weeks). The mean disabilities of the arm, shoulder and hand (DASH) score was 13.21 points (range: 10.3 to 30), thus confirming the patient’s good functional capacity. The higher the DASH score was (i.e. the worse the functional result), the smaller were the flexion (p=0.01), pronation (p=0.03), supination (p<0.0001) and radial deviation (p=0.005) of the wrist that underwent the surgical procedure after the fracture of the distal extremity of the radius. The radiological results were evaluated by modified Lidstrom criteria.
Conclusions: The radiographic results did not influence the DASH score. There was no statistical relationship between the DASH score and the radial height or the volar tilt or the radial tilt of the distal extremity of the operated radius.
References
Peltier LF. Eponymic fractures: John Rhea Barton and Barton’s fractures. Surgery. 1953;34(5):960-70.
Slutsky DJ, Osterman AL. Fractures and injuries of the distal radius and carpus: thecutting edge. Saunders/Elsevier; 2009: 563.
Tang Z, Yang H, Chen K, Wang G, Zhu X, Qian Z. Therapeutic Effects of Volar Anatomical Plates Versus Locking Plates for Volar Barton’s Fractures. Orthopedics. 2012;35(8):1198-203.
Aggarwal A. Open reduction and internal fixation of volar Barton’s fractures: A prospective study. J Orthop Surg (Hong Kong). 2004;12(2):230-4.
Dai M-H, Wu C-C, Liu H-T, Wang I-C, Yu C-M, Wang K-C, et al. Treatment of volar Barton’s fractures: comparison between two common surgical techniques. Chang Gung Med J. 2006;29(4):388-94.
Vasenius J. Operative Treatment of Distal Radius Fractures. Scand J Surg. 2008;97(4):290-6.
Bartl C, Stengel D, Bruckner T, Rossion I, Luntz S, Seiler C, et al. Open reduction and internal fixation versus casting for highly comminuted and intra-articular fractures of the distal radius (ORCHID): protocol for a randomized clinical multi-center trial. Trials. 2011;12:84
Twigt B, Bemelman M, Lansink K, Leenen L. Type C distal radial fractures treated withconventional AO plates: an easy and cost-saving solution in a locking plate era. Int Orthop.2013;37(3):483-8.
Jupiter JB, Fernandez DL, Toh CL, Fellman T, Ring D. Operative treatment of volar intra-articular fractures of the distal end of the radius. J Bone Joint Surg Am. 1996;78(12):1817-28.
Harness N, Ring D, Jupiter JB. Volar Barton’s fractures with concomitant dorsal fracture in older patients. J Hand Surg Am. 2004;29(3):439-45.
Volar Barton’s fractures with concomitant dorsal fracture in older patients. J Hand Surg Am. 2004;29(3):439-45.
Mehara AK, Rastogi S, Bhan S, Dave PK. Classification and treatment of volar Barton fractures. Injury. 1993;24(1):55-9.
Ilyas AM, Ilyas AM. Surgical approaches to the distal radius. Hand. 2011;6:8-17.
Wright TW, Horodyski M, Smith DW. Functional outcome of unstable distal radius fractures: ORIF with a volar fixed-angle tine plate versus external fixation. J Hand Surg Am. 2005;30(2):289-99.
Kwok IHY, 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.
Osada D, Kamei S, Masuzaki K, Takai M, Kameda M, Tamai K. Prospective Study of Distal Radius Fractures Treated With a Volar Locking Plate System. J Hand Surg Am. 2008;33(5):691-700.
Tsukazaki T, Takagi K, Iwasaki K. Poor correlation between functional results andradiographic findings in Colles’ fracture. J Hand Surg Br. 1993;18(5):588-91.
Fujii K, Henmi T, Kanematsu Y, Mishiro T, Sakai T, Terai T. Fractures of the Distal End of Radius in Elderly Patients: A Comparative Study of Anatomical and Functional Results. J Orthop Surg. 2002;10(1):9-15.
Jaremko JL, Lambert RGW, Rowe BH, Johnson JA, Majumdar SR. Do radiographic indices of distal radius fracture reduction predict outcomes in older adults receiving conservative treatment Clin Radiol. 2007;62(1):65-72.
Chung KC, Watt AJ, Kotsis S V, Margaliot Z, Haase SC, Kim HM. Treatment of Unstable Distal Radial Fractures with the Volar Locking Plating System. J Bone Jt Surg. 2006;88(12):2687.
Wakefield AE, McQueen MM. The role of physiotherapy and clinical predictors of outcome after fracture of the distal radius. J Bone Joint Surg Br. 2000;82(7):972-6.
