Dr. K R Raghavendra, Department of Orthopaedics, Bapuji Hospital and Chigateri General Hospital attached to J.J.M. Medical College, Davangere, Karnataka, India. E-mail: raghavendra4uv@gmail.com
Abstract
Background: Volar Barton fractures are unstable intra-articular distal radius fractures characterized by volar displacement of the distal fragment with radiocarpal subluxation. Conservative treatment is often associated with poor outcomes such as malunion, instability, and early osteoarthritis. Variable-angle locking compression plates (VALCP) offer the advantages of anatomical reduction, stable fixation, and early mobilization by allowing screw placement according to fracture geometry and minimizing periosteal compression. Objective of the study is to study the surgical management of Volar Barton fractures with variable angled locking compression plate.
Methods: A prospective study was conducted from April 2022 to November 2023 at tertiary hospitals attached to J.J.M. Medical College, Davanagere. Fifteen adult patients (>18 years) with Volar Barton fractures were managed operatively with VALCP fixation. Patients medically unfit for surgery, those with compound fractures, neurovascular compromise, or unwilling to undergo surgery, were excluded from the study. Functional outcomes were assessed using Modified Cooney, Green, and O’Brien scoring system during follow-up.
Results: Of the 20 patients, 65% achieved excellent results, 25% good, and 5% fair outcomes, and 5% poor results. Early physiotherapy contributed to improved functional recovery. Complications were observed in 2 patients (10%): One is superficial wound infection, and another one is reduced wrist range of motion.
Conclusion: VALCP provide excellent to good clinical and radiological outcomes in Volar Barton fractures, enabling anatomical reduction, stable fixation, and early mobilization. VALCP is a reliable implant for unstable and comminuted Volar Barton fractures, facilitating early return of wrist function and daily activities.
Keywords: Volar Barton fracture, distal radius fracture, variable-angle locking plate, internal fixation, prospective study.
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