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Barton’s Fracture

Barton’s Fracture

An intraarticular shear fracture on the distal radius and radiocarpal joint, typically caused by a direct and violent injury from the wrist or sudden pronation of the distal forearm on a flexed wrist during falling.

Radial Epiphyseal Fracture

A fracture that commonly occurs in pediatric (10-14) forearm fractures, especially in the distal radius, typically resulting from a fall on an outstretched hand with the wrist extended.

• Distal Radius (and Ulna): most common site of pediatric forearm fractures

• Male>Female

• 40% of all pediatric long bone fractures

Salter-Harris Classification

A classification system for physeal disk (growth plate) fractures, categorizing them into Types I through V based on the separation of the growth plate from the metaphysis.

Type 1 = a complete physeal fracture with or without displacement

Type 2 = a physeal fracture that extends through metaphysis, producing chip fracture of metaphysis

Type 3 = a physeal fracture that extends through the epiphysis

Type 4 = a physeal fracture plus epiphyseal and metaphyseal fractures

Type 5 = a compression fracture of the growth plate

Scaphoid Fracture

A fracture of the scaphoid bone in the wrist, often caused by a FOOSH (fall on outstretched hand), with treatment options varying based on displacement and severity.

Triquetral Fracture

A break of the Triquetral bone in the wrist, commonly caused by direct impact (usually a fall onto wrist in dorsiflexion and ulnar deviation), leading to wrist pain on the little finger side, with mechanisms of injury including impaction, avulsion, and shearing force.

Hamate Fracture

A rare fracture often misdiagnosed as a wrist sprain, categorized into hook and body fractures, with potential complications involving the ulnar nerve, artery, and tendons.

Pisiform Fracture

A rare carpal fracture typically resulting from falls on an outstretched hand, with symptoms including ulnar-sided wrist pain, grip weakness, and hypothenar tenderness.

Metacarpal Fracture

A common hand injury divided into fractures of the head, neck, or shaft, with the fifth metacarpal being the most commonly injured site, often associated with pain, swelling, and limitation of movement.

Bennet’s Fracture

Partial articular fractures at the volar-ulnar base of the thumb metacarpal, typically caused by a direct blow in the axis of the 1st metacarpal in a flexed thumb or digits.

Rolando Fracture

A comminuted articular fracture of the base of the thumb metacarpal resulting from compressive forces along the metacarpal shaft when the trapezo-metacarpal articulation is flexed.

Phalanx Fractures

Common hand injuries involving the proximal, middle, or distal phalanx, with the distal phalanx and border digits being most commonly affected.

Seymour Fractures

Displaced distal phalangeal physeal fractures with an associated nailbed injury, often caused by direct trauma or crush injuries.

Lunate/Perilunate Dislocations

High-energy wrist injuries associated with neurological damage and poor functional outcomes, typically caused by falls on outstretched hands or motor vehicle crashes.

Thumb CMC Dislocation

Rare injuries resulting from axial force on a flexed thumb, leading to torn dorsoradial ligaments and symptoms like pain and swelling over the thenar eminence.

MCP Dislocations

Dislocations of the metacarpophalangeal joint, usually dorsal, caused by falls and hyperextension of the MCP joint, commonly affecting the index finger.

Keinbock’s Disease

Necrosis of the lunate bone, with causes believed to involve genetics, leading to potential revascularization attempts or wrist fusion depending on disease stage.

Preiser’s Disease

Avascular necrosis of the scaphoid bone, often caused by repetitive microtrauma or drug side effects, resulting in ischemia and necrosis without prior fracture.

Radial Styloid Fracture

Also known as Chauffer’s or backfire fracture, an intra-articular triangular fracture involving the radial styloid, typically caused by trauma and treated with closed reduction and pin fixation.

Boutonniere deformity

A hand deformity caused by chronic synovitis forcing the MCP joint into flexion, leading to tension in the IP's and resulting in hyperextension, along with the rupture of the central tendinous slip of the extensor hood. Manifests as extension of the MCP and DIP joints, and flexion of the PIP joint.

Symptoms of Barton’s Fracture

• Bruising around the wrist

• Bump on your wrist

• Failure to move wrist without pain

• Numb or tingling fingertips

• Swelling

Symptoms of Radial Epiphyseal Fracture

• Pain

• Swelling

• Deformity

Treatment of Scapoid fracture

• Nondisplaced = long arm thumb spica cast

• Displaced = pin and screw

• Nonunion with pain and arthritic changes = resection of proximal row of carpal bones

Predisposition of a Scaphoid fracture

• Most common overlook fracture in adult at time of injury

• Common in young male adults

Symptoms of Scaphoid fracture

• Swelling and tenderness of thumb and anatomical snuffbox

• Osteonecrosis of bone due to poor blood supply

• Nonunion and avascular necrosis is most common in proximal third