Volar Barton (Palmar rim dislocation) is a palmar rim fracture of distal radius. The most common cause of this type of fracture is a drop on an outstretched hand.

Mechanism

It is due to palmar tensile stress and dorsal shear stress and is usually combined with Radial styloid fracture.

Clinical Features

• Pain

• Swelling

• Tenderness

• Loss of wrist movements

• Palmar flexion is grossly restricted and painful

Radiograph

Palmar rim of distal radial articular surface is displaced dorsally. Proximally and posteriorly and may be associated with dorsal subluxation of the wrist.

Treatment

Conservative

Reduction is simple, but retention is difficult. Long arm cast is used.

Surgery

If reduction does not remain satisfactorily with the wrist in neutral or slight palmar flexion, fixation with K-wire, external fixators and buttress plate, etc. may be done. Ellis T-’shaped buttress plate fixation is the preferred method of treatment.

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