Intra-articular distal radius fracture with dorsal displacement of the distal fragment and carpus subluxation is which fracture?

• A. Colles Fracture
• B. Smith Fracture
• C. Barton's Fracture
• D. Chauffeur's Fracture

Answer: (C)

This pattern tests recognizing a distal radius fracture that involves the joint surface with instability of the radiocarpal joint. Barton’s fracture is defined by an intra-articular fracture of the distal radius that extends into the radiocarpal surface and is accompanied by subluxation or dislocation of the carpus. The dorsal displacement of the distal fragment described here fits with this injury, and the accompanying carpal subluxation reflects the joint instability that characterizes Barton’s fracture. Because the fracture involves the joint surface and disrupts the radiocarpal articulation, it is inherently unstable and typically requires reduction and fixation to restore articular congruity and prevent post-traumatic arthritis.

Colles fracture is an extra-articular distal radius fracture with dorsal angulation but no radiocarpal dislocation. Smith fracture is a distal radius fracture with volar (palmar) displacement, usually also extra-articular. Chauffeur’s fracture is a radial styloid avulsion, not an intra-articular distal radius fracture with carpal subluxation.