Volar Barton fracture: Treatment Comparison of Plating and External fixation with Krischner wires

• Author Details:   
• Jayant Sharma
• Prashant Upadhyaya

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Background: Distal radius fractures are commonly seen and have various treatment methods available in literature hence, a clear consensus could not be reached as to the most ideal modality of management. With advent of buttress plates, open plating has become a treatment of choice in young adults whereas Kirschner wire fixation  with external fixator application have achieved good results in osteoporotic and medically compromised patients.
Methods: Twenty eight patients of distal Radius fractures with volar Barton pattern came to us were either treated by open reduction and plating (16cases) and 12 cases were treated by Kirschner wire fixation with external JESS fixation, with an average follow-up of 18 months (range, 12-24 months).
Results: All the patients had union achieved without any major complications in plating patients (12 out of 16) and 10 out of 12 cases of Kirschner wires with JESS (p=.05).
Conclusion: Surgical techniques discussed here are the two standard procedures with a long follow up, also in the literature are proven to be effective treatment modalities, and are found to give the best possible result with least complication rates. Despite the fact that each technique has its own advantages and side effects, whereas results from the plating treatment seem to be best suited for patients who have minimal commination and are heavy workers and need to join their working soon. Whereas the Kirshner wire and JESS was suited for comminuted fractures and osteoporotic fractures.

Key words: Volar Barton’s fracture, Buttress plate, External fixation, JESS distractor, Kirschner wire