Treatment of Volar Barton's Fractures of the Distal Radius with T-buttress Plates

Aim To evaluate the functional and radiological results of treating unstable volar Barton's fractures of the distal radius with the T-buttress plate. Methods: This was a retrospective study at orthopedic complex in Bahawal Victoria Hospital from January 2009 to August 2010. We used open reduction and internal fixation with a 3.5mmT-buttress plates in volarly displaced, intraarticular fractures of the distal radius which were judged irreducaible or in which closed reduction failed. The volar tilt, radial length, articular step-off and intraarticular gap between fragments were improved after surgery. We included 43 patients, comprising 36 men and 7 women with a mean age of 31 years (range from 20-56 years). Preoperative, postoperative, and final follow-up radiographs were compared. The time to initiation of active range of motion was determined. Final follow-up range of motion and complications were reported. Mean follow-up time after injury was 15.5 months (range 12–24 months) Results: At final functional assessment, the scores of 13 patients were excellent, 23 patients good, and 7 patients fair according to a criteria described by Gartland and Werley. No non-union or infection occurred. Five patients had slight finger contraction and rupture of the flexor pollicis longus tendon occurred in two patients. Conclusion: Treatment of volar Barton's fractures of the distal radius with a 3.5mm T-buttress plates leads to satisfactory results, provided the operative technique is carefully performed to prevent complications.