Rajesh Kolla, Pavan Kumar Babu Aasupathri, Rajaiah D, Rajesh Kumar Mallepogu, Raghavendra Rao Thadi, Amar Tej B
BACKGROUND The distal end of radius fractures continue to pose a therapeutic challenge. Post-traumatic osteoarthrosis decreased grip strength, and endurance, as well as limited motion and carpal instability, are the complications because of intraarticular and extra-articular malalignment1 Barton’s fracture was named after the American surgeon John Rhea Barton. Barton’s fracture is a fracture of the distal end of the radius that involves the articular surface of distal radius and is usually accompanied by subluxation or luxation of the radiocarpal joint. These fractures may result from high- or low-energy injuries, and they account for approximately 1.2 % to 4.2 % of distal radial fractures. Barton’s fractures are classified into volar or dorsal Barton’s fractures based on the site and shifting the direction of fragments. According to AO classification, volar Barton’s fractures are classified as type B3 fractures of the distal radius. Conservative treatment is usually unsuccessful and fraught with complications, such as early osteoarthrosis, deformity, subluxation, and instability. ORIF with a volar Ellis plate system is currently practised for the treatment of volar Barton’s fracture as it results in good reduction and provides immediate stability. Moreover, the patients can be mobilised early and quickly potentially reducing wrist stiffness. MATERIALS AND METHODS This clinical study includes 20 patients with volar Barton’s fracture, which were admitted through OPD and casualty of Government General Hospital, Kurnool.The study was done for a period of 2 years i.e. from November 2016 to November 2018. RESULTS All cases were followed up periodically during the period 2016 to 2018 at 1, 3, 6, 12 months postoperative period, and results evaluated at the end, and scored by Gartland and Werley scoring system. 11 (55%) had an excellent result, 7 (35%) had good result, 1 (5%) had fair and 1 (5%) had a poor result. CONCLUSION Ellis plates gave successful results for the volar Barton’s distal radius fractures. This method, which is effective in anatomic realignment, allows early joint motion, owing to its fixation strength.Close placement to joint interface and screwing capability in different orders are its biomechanical superiorities.The volar approach provides both access with minimal surgical trauma on distal radius and fixation with a better adoption to surrounding tissues. In the subjects of our study, a successful anatomic alignment was acquired with the volar approach, regardless of the direction of fracture angulation. The patients who were young adults in the majority went back to their daily activities with 90% recovery. These Ellis plates not only provide restoration of radial length but also help in stabilizing palmar angulation. They maintain intraarticular congruity thus reducing radiocarpal arthritis and decrease in grip strength. At last, not the least they also provide quicker recovery and better functional range of movement and provide better fixation in an osteoporotic bone.
