Hand Orthopedics Barton Fracture Criteria Calculator

About Barton fractures

A Barton fracture is an intra-articular fracture of the distal radius that involves the rim of the articular surface, along with subluxation or dislocation of the radiocarpal joint in the direction of the broken fragment. John Rhea Barton described it back in 1838. What really defines it is the fracture-dislocation behavior. The carpus and the broken rim fragment shift together, which is exactly why it stays unstable. Depending on which rim of the radius is involved, it gets classified as volar (anterior, more common) or dorsal (posterior, less common).

Clinical criteria and how it is assessed

The diagnosis comes from imaging, with the physical exam backing it up. Here are the features this calculator takes into account:

• An intra-articular fracture line that runs through the volar or dorsal rim of the distal radius.
• Subluxation or dislocation of the radiocarpal joint, where the carpus shifts together with the rim fragment.
• The volar (anterior) pattern usually follows a fall onto a supinated wrist; the dorsal (posterior) pattern follows forced dorsiflexion and pronation.
• What sets it apart from other fracture-dislocations: the radiocarpal ligaments stay intact and the fractured articular surface keeps contact with the proximal carpal row.
• The inherent instability that usually calls for surgical fixation, most often a buttress plate, to rebuild the joint.

Who uses this

Orthopedic and hand surgeons lean on these criteria, and so do emergency physicians, radiologists, residents and physiotherapists. They help spot the fracture-dislocation, get a sense of how unstable it is, and map out the operative fixation.

FAQ

How does a Barton differ from a Colles or Smith? A Barton is intra-articular and comes with joint subluxation or dislocation. The classic Colles and Smith fractures, by contrast, are extra-articular.

Is volar or dorsal more common? You see the volar (anterior) type more often.

This tool is educational only and does not replace a medical evaluation. If you suspect a distal radius fracture-dislocation, a qualified clinician still needs to examine it, order radiographs and make the treatment call.