35 patients with volar Barton fractures were treated operatively from
1985-1994. The injury was due to a high velocity motor vehicle accident
in 20 patients. All fractures were closed without major carpal injuries.
11 fractures were type B3.1, 21 type B3.2 and 3 type B3.3, according to
the AO classification. All fractures were openly reduced and internally
fixated by small buttress plates and screws. In 31 cases, the median
nerve was unaffected by the injury and was not explored or decompressed
during surgery.
The patients were assessed clinically and radiographically after mean 6
(2-10) years. According to the criteria of Pattee and Thompson (1988),
23 patients had excellent results, 10 good and 2 fair. Posttraumatic
arthrosis was found in 12 patients and was related to the congruency of
the articular surface achieved at surgery. We conclude that the median
nerve, when not damaged or compressed, should not be explored or
decompressed during surgery
