Treatment of Hand Joint Pain:
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
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 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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