Background :

Distal radius fractures are common, with volar Barton fractures posing a unique challenge due to their intra-articular nature and instability. These injuries often result from high-energy trauma and involve dislocation of the radiocarpal joint.

Conservative treatment frequently yields poor outcomes, prompting a shift toward surgical management. Volar buttress plating via open reduction and internal fixation (ORIF) has emerged as the preferred approach, offering stable fixation, early mobilization, and favorable functional recovery.

Anatomically contoured low-profile plates enhance outcomes by minimizing soft tissue complications. Despite some risks, such as tendon irritation, clinical results have generally been positive when appropriate surgical protocols are followed.

Aim of the Study :

This study aims to evaluate the treatment outcomes of volar Barton fractures of the distal radius managed with volar buttress plates.

Methods :

This prospective observational study was conducted over 12 months, from July 2023 to June 2024, at the Department of Orthopaedics of Pabna Medical College, Bangladesh, to evaluate outcomes of volar Barton fractures treated with open reduction and internal fixation using a volar buttress plate.

Thirty (30) adult patients with closed, radiologically confirmed volar Barton fractures were included. The surgery involved a standard volar (Henry?s) approach with fixation using locking or non-locking screws.

Postoperative care included early mobilization and radiographic follow-up at 2, 6, and 12 weeks postoperatively. Outcomes were assessed radiologically and functionally using the Mayo Wrist Score. Data were analyzed descriptively using SPSS version 26.0 without inferential statistics.

Results :

In this study of 30 patients with volar Barton fractures treated using buttress plate fixation, most were males (70%) aged 30?50 years (53.33%), with the right hand predominantly affected (93.33%).

The primary cause was falls on an outstretched hand (56.67%). Radiographic union occurred within 6?12 weeks in 70% of cases, and final alignment was maintained in 90% of cases.

Functional assessment using the Mayo Wrist Score showed excellent to good outcomes in 86.67% of patients.

Complications were minimal, including superficial infection (3.33%), tendon irritation (3.33%), and implant prominence (6.67%). No cases of deep infection, implant failure, or reduction loss were reported.

Conclusion :

Volar buttress plate fixation is an effective treatment for volar Barton fractures, promoting early union, stable anatomical reduction, and good functional recovery with minimal complications.

Optimal outcomes depend on selecting appropriate patients, performing surgery promptly, and employing precise surgical techniques.