2.  68 yo female presents after  T 97.6 P 98 BP 159/86 O2
slipping and falling while 97%
getting out of the shower.  Gen: In obvious pain but
Pt fell forward onto her NAD
outstretched hand, with  MSK- obvious dorsal
her wrist extended. Pt deformity/swelling to right
complains of extreme pain
wrist, limited range of
in her left wrist, and denies motion in right wrist, 1+
hitting her head or any radial pulse
other injuries.
 Neuro- limited
flexion/extension right
wrist, nl sensation
throughout

4. Distal radius fracture w/ dislocation of radiocarpal joint

5.  Pain Control
 Reduction of fracture, usually under conscious
sedation
 Ortho consult needed, as non-op treatment usually
fails
 Stability of reduction of dorsal Barton fx is best
obtained with wrist extension to take advantage of
intact volar carpal ligament

6.  Most common fx dislocation of the wrist joint;
- comminuted fx of distal radius may involve
either anterior or posterior cortex and
may extend into the wrist joint
 Fx dislocation or subluxation in which the rim of distal
radius (dorsally or volarly) is displaced with the hand and
carpus;
- it often occurs along with a radial styloid frx
- it differs from Colles' or Smith's Fracture in that the
dislocation is the most striking radiographic finding
 More common for distal fragment to be displaced dorsally,
although it can dislplace volarly also (volar Barton’s fx)

8.  http://www.wheelessonline.com/ortho/dorsal_barton
s_fracture_dorsal_shearing_frx
 http://www.freebase.com/view/en/distal_radius_fract
ure
 http://myradnotes.wordpress.com/2008/06/
 http://www.radiologyassistant.nl/en/476a23436683b