Volar Barton Fracture Treatment with T Plate Using Distal End Screws and Without Distal End Screws; A Comparative Study
DOI:
https://doi.org/10.21649/akemu.v31i1.5724Keywords:
Volar Barton fracture, T-plates, Functional outcome, Distal End ScrewsAbstract
Background: Volar Barton's fractures are the fracture of distal radius with intra-articular extension associated with
dislocation and subluxation of radiocarpal joint requiring surgical treatment with volar plate to achieve anatomical
reduction.
Objective: To compare Volar Barton's fracture treatment deploying T-buttress plate with and without distal end screws in terms of pain, activities, grip strength and functional outcome of hand and wrist.
Methods: The patients were divided in two groups by using opaque sealed envelope method. All the findings of study variables such as age, gender, residence, height, weight, BMI, duration of fracture and functional outcome were noted in a predesigned Proforma.
Results: Total of 68 patients (34 in each), mean age of the group with distal end screw was calculated as 41.44±6.01
years and mean age of the group with distal end screw was 44.21±5.22 years. There were 25 males and 9 females in the group without distal end screw and 28 males and 6 females in the group with distal end screw. Green O Brein score was 88.94+ 7.26 in the group without distal end screw and 84.08+8.09 in the group with distal end screw. (p=0.011) Total of 68 patients (34 in each), 67.7 %(n=23) had excellent, 30.8 %(n=8) good, 50.0 %(n=2) fair and 25.0 %(n=1) had poor functional outcome in T-plate without distal end screw group, 32.4 %(n=11) had excellent, 69.2 %(n=18) good, 50.0%(n=2) fair and 75.0 %(n=3) had poor outcome and in T-plate with distal end screw group. (p=0.028)
Conclusion: It was concluded form this study results that T-plate without distal end screw group can provide excellent results in treating volar Barton's fractures.
References
1. Gawali SR, Hardikar SM, Prakash S, Nadkarni S. Management of intra-articular fractures of distal end radius in adults. Int J Res Orthop. 2016;2(4):220-28.
2. Murugesan AK, Govindasamy R, Ismail PY. Open reduction and internal fixation of volar Barton’s fractures by polyaxial locking plates: a retrospective study. Int J Res Orthop. 2019; 5(5):800-4.
3. Masood F, Sah RK, Sarfaraz AH. Faisal’s Technique to Closely Manage Volar Barton’s Fracture: A Pilot Study. Ann King Edw Med Univ. 2018; 24(1):679-83.
4. Cha SM, Shin HD, Ga IH, Kim YH. Certain fracture patterns in children/adolescents would be better called ‘Barton equivalent’ fractures. J Pediatr Orthop. 2025;34(2):134-41.
5. Prakash Wali D, Mared S. A retrospective clinical study of volar Barton fractures using t-Elli's plate and locking distal end radius plate and screws. Int J Orthop. 2018;4(1):364-7.
6. Ali M, Hafeez Z, Rehman MU, Rabbani S, Saleem M, Ali AY, et al. Radiological and Clinical Outcome of Volar Barton Distal Radius Fractures Treated by Variable Angle Volar Locking-Plates (Chinese Version). J Rawalpindi Med Coll. 2019;23(1):51-4.
7. Kolla R, Aasupathri PK, Rajaiah D, Mallepogu RK, Thadi RR, Tej A. A study of surgical management of volar barton’s fractures using ellis plate. J Evid Based Med Healthc. 2019;6(8):534-8.
8. Szymanski JA, Reeves RA, Taqi M, Carter KR. Barton Fracture. [Updated 2023 May 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025:29763081.
9. Kochi K. Surgical Outcome of Volar Locking Tplate of Volar Barton Fracture. Int J Acad Med Pharm. 2024;6(2):1217-22.
10. Madhukar SN, Pugazhendhi G, Vijayanarasimhan SA, Venkatachalam K. Functional outcome of volar Barton’s fracture treated with volar plate osteosynthesis. Sch Acad J Biosci. 2016;4(3):237-43.
11. Shah H, Chavali V, Daveshwar R. Adolescent Volar Barton Fracture with Open Physis treated with Volar Plating using Buttressing Principle. Malays Orthop J. 2015;9(2):47-50.
12. Ashour ME, Kandil MI, Hassan MH. External Fixation versus Open Reduction with Plate Fixation for Distal Radius Fractures. Benha J Appl Sci. 2022 ;7(1):7-12.
13. Zhao Y, Liao Z, Liu Y, Nijhuis KO, Barvelink B, Prijs J, et al. A Landmark-Based Approach for Instability Prediction in Distal Radius Fractures. IEEE International Symposium on Biomedical Imaging (ISBI), Athens, Greece, 2024:1-5, doi: 10.1109/ISBI56570.2024.10635424.
14. Dündar A, Çankaya D, Karakuş D, Tabak AY. Volar-locking plate versus external fixator in the management of distal radius fractures: An isokinetic study. Ulus Travma Acil Cerrahi Derg. 2022;28(8):1156-63.
15. Nishida K, Che YH, Irifune H, Uesugi K, Maeda A, Miyata K. Dynamic External Fixator Combined with Volar Locking Plate Fixation for the Treatment of AO Type C3 Distal Radius Fractures. Open J Orthop. 2022;12(4):131-41.
16. Fleifel D, Pytiak AV, Jin X, Cizmic Z, Vaidya R. Biomechanics of Subcutaneous Locked Plating Versus Burke Plate and External Fixator for Comminuted Distal Radius Fractures. Cureus. 2023;15(5):39142. doi: 10.7759/cureus.39142
17. Kapoor H, Agarwal A, Dhaon BK. Displaced intra- articular fractures of distal radius: a comparative evaluation of results following closed reduction, external fixation and open reduction with internal fixation. Injury. 2000; 31 (2): 75-9.
18. Sahito B, Tariq SM, Mamji F, Doultani D, Ali M, Hussain N. Outcome of open reduction and internal fixation of volar Barton fracture treated with Buttress plate/ locking plate. RMJ. 2015; 40(4): 406-8.
19. Islam MA, Kumar N , Haque R , Barmon SC , Shahidullah M , Forhad S et al. Functional Outcome of Patients Undergoing Volar Buttress Plate for Fixation in Volar Barton’s Fracture of the Distal Radius. SAS J Surg. 2022;8(1):10-4.
20. Chen H, Zhao Z, Li J. Fracture of the Distal Radius. In Orthopaedic Trauma Surgery: Volume 1: Upper Extremity Fractures and Dislocations. 2023rd edition. Springer Singapore. 2023; 251-88.
21. Ravinath TM, Shariff SM, Agarwal N, Rajendra P, Mendiratta D. A prospective study in surgical management of distal end radius fracture with variable angle locking compression plate. Int J Orthop Sci. 2021;7(1):703-12.
22. Ibrahim AM, Soudy EE, Nafea WM, Farhan AH, Fouda NM. Open reduction and internal fixation with a small T-plate for volar barton fracture management. Egypt J Hosp Med. 2021 ;85(2):4240-5.
23. Laghari AR, Mahar SA, Palh HB, Ahmed W, Bhutto AM, Hussain F, et al. Outcome of volar barton fractures treated with locking compression plates: a cross-sectional study: volar barton fractures treated with locking compression plates. PJHS. 2022:142-6.
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