Learning Radiology xray montage

Barton Fracture

General Considerations

  • Intra-articular fracture of the distal radius with subluxation/dislocation of the wrist
    • The lunate maintains its relationship with the fracture fragment
  • May involve the volar aspect of the radius (sometimes called “reverse Barton fracture”) or the dorsal aspect
  • Volar type is more common
  • Most common fracture-dislocation of the wrist

Clinical Findings

  • Dorsal Barton’s fracture usually results from fall on an out-stretched hand
  • Volar-type is caused by the same mechanism as a Smith fracture
  • Result is deformity at wrist joint
  • Pain, tenderness, swelling and decreased range of motion

Imaging Findings

  • Conventional radiographs are the study of first choice
  • Fracture is wedge-shaped and extends obliquely on the lateral view into the radiocarpal joint
  • Carpal bones and hand maintain their relationship with the fracture fragment, separating from the remainder of the radius
  • Frequently associated with ulnar styloid fractures
  • CT if further definition is required

Differential Diagnosis

  • Colles fracture-extra-articular fracture of the distal radius with dorsal angulation
  • Smith fracture-a fracture of the distal radius with palmar angulation
    • May have intra-articular component, but dislocation is not a feature as in Barton fracture


  • Most require operative treatment


  • May re-dislocate
  • Malunion


Barton's Fracture-Dislocation of the Wrist. The frontal radiograph shows a
fracture of the distal radius (red arrow) and ulnar styloid (white arrow). The lateral radiograph demonstrates a dorsal, wedge-shaped, intra-articular fracture of the
distal radius (yellow arrow), with which the carpal bones (green arrow) have dislocated posteriorly.

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Barton fractures. Wheeless' Textbook of Orthopaedics