Barton Fracture

What is a Barton fracture?

A Barton fracture is where you break part of your wrist and knock another part out of place. It usually happens when you fall on top of your bent wrist.

The part of your wrist that breaks (your distal radius) is also part of your forearm. Your radius is the most commonly broken arm bone. These breaks make up about 20% of all broken bones.

What are the different types of Barton fractures?

There are two types of Barton fractures. If the bump is on the back of your hand, it’s called a dorsal Barton fracture. If the bump is on the palm side, it’s called a volar or reverse Barton fracture. Reverse fractures happen more often.

Who gets Barton fractures?

Barton fractures can happen to anyone because anyone can fall. But, 70% of the time, this kind of fracture happens to young men who are either manual workers or motorcyclists. They get hurt on the job or in an accident.

You’re also at a higher risk if you have osteoporosis. Osteoporosis is a disease that weakens your bones. Weak bones are more likely to break. If you're over 50, then you're at an increased risk for this disease.

How common are Barton fractures?

Barton fractures are rare. There are many other, more common wrist fractures.

What causes this type of fracture?

A fall is almost always the cause of this kind of fracture. Car and motorcycle accidents can also cause this break.

What are the symptoms?

Barton fracture symptoms are about the same as of other types of distal radius breaks. The symptoms include:

• Bruising around your wrist.
• Bump on your wrist.
• Failure to move your wrist without pain.
• Numb or tingling fingertips.
• Swelling.
• Wrist pain.

How are Barton fractures diagnosed?

When you see your healthcare provider, they’ll want you to list your symptoms, describe how bad they are and explain how you hurt your wrist. Your provider will order an X-ray to make sure that you have a broken bone and to figure out the type of break. The X-ray will also show them:

• If other bones are broken.
• The amount of space between the broken pieces.
• The roughness or smoothness of the broken bone.

You might need a CT scan or MRI. These tests check for problems with your tendons, muscles and ligaments.

What questions might a healthcare provider ask to diagnose a Barton break?

• How much pain are you in?
• How severe are your symptoms?
• Are you able to move your wrist?
• How did you hurt your wrist?
• When did you hurt your wrist?

How is this kind of broken bone treated?

Your healthcare provider will place your wrist in a splint and then refer you to an orthopaedic surgeon. Orthopaedic surgeons treat problems with your bones, muscles, tendons, ligaments and soft tissues. You’ll likely need a surgical procedure called an open reduction and internal fixation (ORIF).

An ORIF puts the bone fragments of your wrist back together. There are two steps:

• Open reduction. The surgeon makes a cut, finds the broken bones and moves them back to where they were before the injury.
• Internal fixation. The surgeon puts the bones together using pins, rods, plates, screws, or a combination.

Your healthcare provider might tell you to take medications like acetaminophen (Tylenol®) and ibuprofen (Advil®, Motrin®) to help with the pain.

How long does it take to heal from a Barton fracture?

If you don’t get surgery, you’ll have to wear a cast around your wrist for about six weeks and then go to physical therapy. At therapy, you'll work on your wrist movement and strength. You may feel better in a few months, but healing can take a year. Be sure to ask your healthcare provider about when you can resume exercise, and when you get back to contact sports like soccer or hockey.

How can I reduce my risk?

Be extra careful when you're playing sports, working manual labor, riding a motorcycle or climbing something high like a ladder. If you’re at higher risk for osteoporosis, eliminate tripping hazards in your home. Be sure to always use your cane or walker if you use one.

What’s the outlook/prognosis for a Barton fracture?

Most people go back to their usual daily activities after a Barton fracture.

What are the complications?

Sometimes problems happen after surgery (complications). Possible Barton fracture complications include:

• Acute compartment syndrome (ACS). ACS can stop blood from getting to important parts of your body. This could damage your nerves and muscles.
• Bone infection (osteomyelitis). If you have an open wrist fracture (the bone breaks through your skin), you have a higher risk of infection.
• Carpal tunnel syndrome. A broken wrist that doesn’t heal right might lead to carpal tunnel syndrome. The syndrome causes pain, weakness and numbness. There are treatments that help.
• Complex regional pain syndrome (CRPS). CRPS is a painful condition that happens when your nerves don’t work right and are irritated following your injury.
• Malunion. Malunion is when your broken bones don't line up right when they heal.
• Other damage. Broken bones can damage the area around them, including your muscles, blood vessels, nerves, ligaments and tendons.

Talk with your healthcare provider if you're worried about complications. Some treatments can help.

When should I contact my healthcare provider?

If you’re 50 or older and you’ve had a bone fracture, your primary healthcare provider might want to test you for osteoporosis. A fracture could mean your bones are weak.

When should I go to the emergency department?

It's best to go to the emergency department if you think you have a broken wrist — especially if your pain is really bad, your wrist looks different, is numb or your fingers are a different color than they usually are.

What questions should I ask my healthcare provider?

• Do I need surgery?
• What kind of broken bone do I have?
• When can I get my cast off?
• When can I get back to my usual activities?

A note from Cleveland Clinic

If you fall on your bent wrist, you could break part of it and move another part out of place. If the joint seems out of place, you might have a Barton fracture. X-rays help healthcare providers figure out the kind of break, and the healing starts with surgery.

Go to your nearest emergency department right away if you have symptoms of a Barton fracture. Breaks are treatable, and quick treatment can lessen the pain and start healing.