Oh, did you fall somewhere and hurt your wrist badly? Or maybe you got stuck in something like a fall from a bike and your wrist got sprained? Imagine, in a situation like this, not only does a bone in your wrist break, but at the same time, a joint in that area is dislocated, and pieces of bone are thrown here and there. That's what we call a Barton Fracture, a slightly more complicated fracture. Since this can be a bit serious, let's talk about it in detail, okay?
What exactly is a Barton Fracture?
Simply put, a Barton Fracture is when part of your wrist breaks and another part is displaced from its original position. To be precise, the radius, which is the bone closest to the wrist, is the one that breaks . It is also connected to the wrist joint, so this problem occurs with that joint.
This often happens when you bend your arm, meaning your wrist, and fall with your weight on that side. Imagine, you were running and suddenly slipped and hit your hand on the ground, that's when this fracture can occur. In fact, the radius bone is the most commonly broken bone in our hand. Overall, only 20% of all other fractures are radius fractures!
Are there types of Barton Fractures?
Yes, there are two main types of Barton fractures, depending on which side the bone fragment is displaced.
1. Dorsal Barton Fracture: This is when the broken bone piece protrudes onto the back of your hand, where the nail is. This can cause a small swelling to appear on the back of your hand.
2. Volar Barton Fracture (also known as Reverse Barton Fracture): This is where the broken bone piece protrudes out into your arm. Surprisingly, these are the most common types of reverse Barton fractures.
Who is more likely to develop Barton Fractures?
Actually, anyone can get a fracture like this. Because who knows when or how it will happen, right? However, according to surveys, 70% of these Barton fractures are reported among young men . This is especially common among manual workers or motorcyclists. This injury can occur in the workplace or in a bike accident.
Also, if you have a condition called osteoporosis , you are also at higher risk of developing this fracture. Osteoporosis, simply put, is a disease in which the bones become weak and easily breakable. So, when the bones are weak, even a small fall can cause serious damage. Generally, the risk of developing this disease increases after the age of 50.
How common are Barton Fractures?
To be honest, Barton fractures are a relatively rare type of fracture . There are many other, more common types of fractures in the wrist. Therefore, not every wrist fracture is a Barton fracture.
What are the main reasons for this breakup?
Most often, that is, most often, this is caused by a fall . As mentioned earlier, this happens when you fall so that your hand touches the ground. In addition, such fractures can also occur in severe accidents such as car accidents and motorcycle accidents.
What are the symptoms of a Barton Fracture?
The symptoms of a Barton fracture are very similar to those of other fractures of the distal radius that we discussed earlier. You may experience things like:
- Bruising and bruising around the wrist: After a fall, the area may become blue and bruised.
- A swelling or bump in the wrist area: When the bone fragment moves, it can swell and appear like a bump.
- Inability to move the wrist without pain: The pain can be so severe that you can't even move your hand.
- Numb or tingling fingertips: Sometimes, if there is a slight pressure on the nerves, the fingertips may feel numb.
- Swelling: The wrist can become very swollen.
- Severe wrist pain: This is the main symptom. The pain can be unbearable.
Imagine, if you fell while playing cricket and injured your hand like this, you would be unable to do your daily activities. Therefore, it is very important to seek medical advice immediately if you experience symptoms like these.
How do doctors diagnose a Barton Fracture?
When you go to see a doctor, he or she will first ask you about your symptoms, how severe they are, and how the injury happened. Then, the doctor will order an X-ray to see if you have a broken bone and what type of fracture it is. The X-ray can help the doctor see:
- Are there any other broken bones?
- How far apart are the broken bone fragments?
- Whether the surface of the broken bone is rough or smooth.
Sometimes, a CT scan or MRI may be done to see if there is any damage to your tendons, muscles, and ligaments.
Questions the doctor may ask you
- "How much pain are you in?"
- "How severe are your symptoms?"
- "Can you wiggle your wrist?"
- "How did you injure this wrist?"
- "When did this injury occur?"
The doctor will be able to accurately understand the situation based on your answers to questions like these.
How do you treat a fracture like this?
Your doctor will first put a splint on your wrist to keep it from moving. Then, he or she will refer you to an orthopedic surgeon. Orthopedic surgeons treat injuries to bones, muscles, tendons, and ligaments.
Most likely, you will have to undergo a surgery called Open Reduction and Internal Fixation (ORIF) . This may sound like a complicated name, but in simple terms, it works like this:
1. Open Reduction: The surgeon makes a small incision in the skin, locates the broken bone fragments, and puts them back in their original position.
2. Internal Fixation: Then, the bone fragments that have been brought into the right place are held together using small pieces of wire (pins), rods, plates, screws, etc. Sometimes several of these can be used together.
To reduce pain after this surgery, your doctor may recommend taking painkillers such as acetaminophen (e.g. Tylenol®) and ibuprofen (e.g. Advil®, Motrin®) .
How long does it take for a Barton Fracture to heal?
This may vary from person to person. But in general,
- If you don't have surgery (which may not be necessary in some cases, but surgery is often necessary for a Barton fracture), you will need to wear a cast around your wrist for about six weeks.
- Even after surgery, you may have to wear a plaster cast or splint for a while.
- After that, you will need to undergo physical therapy , where you will gradually regain movement and strength in your wrist.
You will start to feel better in a few months. However, it may take up to a year for your arm to fully heal and regain its strength. Therefore, it is important to be patient and participate in treatment. Be sure to ask your doctor when you can start exercising again and when you can play contact sports like football and hockey.
How can this risk be reduced?
We can't predict when and how these dangers will occur. But we can be a little careful:
- Be extra careful when playing sports, doing manual labor, riding a motorcycle, or climbing high places like ladders.
- If you are at high risk for osteoporosis (especially if you are over 50 years old), remove tripping hazards in your home.
- If you use a cane or walker, don't forget to use them regularly.
What is the outlook after a Barton Fracture? (Outlook/Prognosis)
The good news is that most people can return to their normal daily activities after a Barton fracture. However, it takes time, proper treatment, and proper physical therapy.
What are the possible complications after surgery?
Sometimes, complications can occur after surgery. There is a small chance that these things will happen after surgery for a Barton's fracture:
- Acute Compartment Syndrome (ACS): This is when blood flow to vital parts of the body is cut off. This can cause damage to nerves and muscles. This is an emergency.
- Osteomyelitis: If you have an open fracture – meaning the bone has broken through the skin – you are at higher risk of developing an infection.
- Carpal Tunnel Syndrome: This condition can occur if a broken wrist does not heal properly. It can cause pain, weakness, and numbness. But there are treatments for this.
- Complex Regional Pain Syndrome (CRPS): This is a very painful condition. It occurs when nerves become overstimulated after an injury, causing them to malfunction.
- Malunion: This means that when your broken bone pieces heal, they don't fit together properly and are misaligned.
- Other damage to surrounding tissues: Broken bones can also damage surrounding muscles, blood vessels, nerves, ligaments, and tendons.
If you are worried or have any concerns about these complications, be sure to talk to your doctor. There are good treatments for some things.
What are the best times to see a doctor?
- If you are over 50 years old and have ever broken a bone, your primary healthcare provider may want to check you for osteoporosis. Breaking a bone means your bones may be weak.
When do you need to go to the Emergency Department?
If you think you may have broken your wrist, it's best to go to the nearest emergency room immediately . Especially if:
- If your pain is very severe.
- If your wrist looks strange (like it's deformed).
- If the wrist is numb.
- If your fingers have changed color (like blue, white, or pale).
Important questions to ask your doctor
When you see the doctor, don't forget to ask these questions:
- "Do I really need surgery?"
- "What kind of fracture do I have?"
- "When will I be able to take off my plaster?"
- "When can I go back to my normal activities?"
The most important thing to remember (Take-Home Message)
Remember, if you fall with your wrist bent, part of it may break and part of it may be dislocated. This means you may have a Barton Fracture. If the joint looks like it's out of place, it could be a Barton Fracture. X-rays can help doctors determine exactly what type of fracture it is. In most cases, surgery is the best treatment.
If you have symptoms of a Barton Fracture, go to the nearest emergency room immediately . These fractures can be treated, and if treated quickly, you can reduce pain and start healing faster. Wishing you a speedy recovery!
` Barton fracture, wrist fracture, hand fracture, wrist pain, bone surgery, ORIF surgery, bone healing
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