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Barton's fracture

  Barton's fracture, also known as the fracture of the distal radial joint surface with oblique longitudinal fracture and wrist subluxation, was first described by J.R. Barton in 1838 and named after him. It usually occurs when the palm or back of the hand hits the ground during a fall, causing the force to be transmitted upwards and resulting in a fracture of the radial joint surface through the impact of the distal row of carpal bones. The fracture line is oblique to the distal end of the radius, and most cases are accompanied by subluxation of the wrist joint.

 

Table of Contents

1. What are the causes of Barton's fracture
2. What complications can Barton's fracture easily lead to
3. What are the typical symptoms of Barton's fracture
4. How to prevent Barton's fracture
5. What laboratory tests are needed for Barton's fracture
6. Dietary taboos for patients with Barton's fracture
7. Conventional methods of Western medicine for the treatment of Barton's fracture

1. What are the causes of Barton's fracture

  1. Causes of Disease

  It is usually caused by indirect violence.

  2. Pathogenesis

  It usually occurs when the palm or back of the hand hits the ground during a fall, causing the force to be transmitted upwards and resulting in a fracture of the radial joint surface through the impact of the distal row of carpal bones. The fracture line is oblique to the distal end of the radius, and most cases are accompanied by subluxation of the wrist joint.

 

2. What complications can Barton's fracture easily lead to

  In addition to general symptoms, it may also cause other diseases. This condition may cause swelling, tenderness, and joint deformity in the wrist. Therefore, once discovered, it requires active treatment, and preventive measures should also be taken in daily life. It should attract the high attention of clinical doctors and patients.

3. What are the typical symptoms of Barton's fracture

  Classification: Depending on the mechanism of occurrence and the characteristics of the fracture line, it can be divided into the following two types.

  1. The dorsal type is more common, occurring when the palm hits the ground during a fall due to the hand's extension, causing a fracture on the dorsal aspect of the distal end of the radius. The fracture fragments tend to displace towards the dorsal side, often accompanied by subluxation of the wrist joint.

  2. The ulnar-sided type is rare, occurring when the back of the hand hits the ground during a fall, causing the stress direction to run along the distal end of the radius towards the palm side, with the fracture fragment displaced towards the palm side. The wrist joint may also exhibit subluxation, and some people classify this type as one of the Smith's fractures.

 

4. How to prevent Barton's fracture

  Fracture patients are mainly young and middle-aged people and the elderly, followed by traffic accidents, industrial accidents, and other external injuries. This requires people to have a sense of prevention in their daily lives. When performing daily actions such as running, jumping, bouncing, and walking, they must be mentally prepared, focused, and not be careless. Coordination of the movement of the whole body's bones will reduce or prevent the occurrence of fractures. Especially for the elderly with osteoporosis, the bones become brittle and hard, and often lead to fractures due to unintentional movements. Immediate hospital visits are required when fractures occur.

 

5. What kind of laboratory tests are needed for Barton's fracture?

  At the time of diagnosis, in addition to relying on clinical manifestations, auxiliary examinations are also needed. On the lateral X-ray film of this disease, the fracture is located on the dorsal side of the distal end of the radius, including 1/3 of the articular surface, and it is mostly displaced towards the dorsal and distal sides, with the wrist joint in a dorsal semi-dislocation state.

6. Dietary taboos for Barton's fracture patients

  One: Barton's fracture diet recipe:

  1. Decoct a proper amount of red beans, add a little brown sugar, and take it warm. This recipe is suitable for the blood-activating and blood-clotting stage.

  2. Take 1000 grams of pork bone, 250 grams of soybeans, add water, simmer over low heat until soft, add salt and ginger for seasoning, and eat it.

  3. Clean one set of pork backbone, 120 grams of red dates, 90 grams of lotus seeds, 9 grams of Ding Xiang and raw licorice, add water, simmer over low heat until soft, add ginger and salt for seasoning, and drink it in several doses.

  4. Take the meat of two fresh crabs (with yolk), add it to the cooked glutinous rice, add a moderate amount of ginger, vinegar, and soy sauce, and eat it. Take it regularly.

  5. Take one male chicken (about 500 grams), remove the skin, feathers, and internal organs, clean it, slice 5 grams of 'Sanqi', put it into the chicken stomach, add a small amount of yellow wine, steam it over water, and serve it with soy sauce after it is cooked. Take it regularly.

  6. Take 30 to 60 grams of raw Astragalus membranaceus, decoct it into a concentrated juice, add 100 grams of glutinous rice, cook it into porridge, and eat it in the morning and evening.

  7. Take 20 grams of Angelica sinensis, 100 grams of Astragalus membranaceus, and one young hen, cook them together in water for soup and eat it.

  8. Take 50 grams of Salvia miltiorrhiza, wash it clean, boil it in water, take the juice, and cook it with 1000 grams of pork long bone and 250 grams of soybeans. When they are cooked through, add a small amount of cinnamon and salt to make it.

  9. Grind 500 grams of fresh crab, mix with 250 grams of hot yellow wine, apply the residue to the affected area, and it is good when 'ge ge' sounds for about half a day. Used for fracture treatment.

  Two: What foods are good for the body with Barton's fracture?

  Eat more protein-rich foods, such as chicken, fish, and other foods.

  Three: What foods should be avoided for Barton's fracture?

  1. Avoid blind supplementation of calcium. Calcium is an important raw material for bone formation. Some people believe that after a fracture, increasing calcium intake can accelerate the healing of the broken bone. However, scientific research has found that increasing calcium intake does not accelerate the healing of broken bones, and for long-term bedridden fracture patients, there is a potential risk of increased blood calcium levels, accompanied by decreased blood phosphorus levels. This is due to the fact that long-term bed rest inhibits the absorption and utilization of calcium on one hand, and increases the reabsorption of calcium by the renal tubules on the other hand. Therefore, for fracture patients, there is no lack of calcium in the body. As long as they strengthen functional exercises and start moving as soon as possible according to the condition and the doctor's instructions, they can promote the absorption and utilization of calcium by the bones, accelerate the healing of broken bones. Especially for patients who lie in bed after a fracture, blindly supplementing calcium has no benefit and may even be harmful.

  2. Avoid eating too much meat bones Some people think that eating more meat bones after a fracture can promote early healing. However, this is not the case. Modern medicine has proven through multiple practices that eating more meat bones after a fracture not only does not promote early healing but can also delay the healing time of fractures. The reason is that the regeneration of bone after injury mainly relies on the function of the periosteum and bone marrow. The periosteum and bone marrow can only better exert their function under the condition of increasing collagen. The main components of meat bones are phosphorus and calcium. If a large amount of them is consumed after a fracture, it will promote the increase of inorganic components in the bone, causing an imbalance in the proportion of organic matter in the bone, thereby hindering the early healing of fractures. However, fresh meat bone soup tastes delicious and has a stimulating effect on appetite, so eating a little is not a problem.

  3. Avoid dietary imbalance Fracture patients often have local edema, congestion, hemorrhage, and muscle tissue damage. The body itself has the ability to resist and repair these conditions. The raw materials for the repair of tissues, the growth of long bones, the formation of callus, and the elimination of blood stasis and swelling depend on various nutrients. Therefore, it can be known that the key to the smooth healing of fractures is nutrition.

  4. Avoid indigestible foods Fracture patients, due to the restriction of activity caused by the fixation of plaster or splints, and the swelling, pain, and mental distress at the injury site, often have a poor appetite and constipation. Therefore, food should be both nutritious and easy to digest and defecate. It is advisable to avoid eating foods that are easy to cause flatulence or indigestion, such as taro, yam, and glutinous rice, and to eat more fruits and vegetables.

  5. Avoid drinking too little water Fracture patients, especially those with spinal, pelvic, and lower limb fractures, are very inconvenient in movement, so they try to drink less water to reduce the frequency of urination. Although the frequency of urination is reduced, even greater troubles have arisen. If the bedridden patient has less activity, weakened intestinal peristalsis, and in addition to reduced water intake, it is easy to cause constipation. Long-term bed rest and urinary retention can also easily induce urinary tract stones and urinary tract infections. Therefore, bedridden fracture patients should drink water as needed without any concerns.

  6. Avoid excessive intake of sugar. Excessive consumption of sugar can cause a rapid metabolism of glucose, leading to the production of intermediate metabolites such as pyruvate and lactic acid, causing the body to be in an acidic中毒 state. At this time, alkaline calcium, magnesium, and sodium ions will be immediately mobilized to participate in neutralization to prevent the blood from becoming acidic. Such a large consumption of calcium is not conducive to the recovery of fracture patients. At the same time, excessive sugar intake can also reduce the content of vitamin B1 in the body, which is essential for the conversion of sugar into energy in the body. Insufficient vitamin B1 greatly reduces the activity of nerves and muscles, and also affects the recovery of function. Therefore, fracture patients should avoid eating excessive sugar.

  7. Avoid long-term use of Sanqi tablets in the early stage of fractures. Local bleeding occurs, blood stasis accumulates, resulting in swelling and pain. At this time, taking Sanqi tablets can constrict local blood vessels, shorten clotting time, increase thrombin, which is very appropriate. However, after one week of fracture reduction, bleeding has stopped and the damaged tissue begins to repair. Repair requires a large amount of blood supply. If Sanqi tablets are continued to be taken, the local blood vessels are in a contracted state, blood circulation is not smooth, which is not beneficial to fracture healing.

  8. Avoid drinking fruit juice during fractures.

7. Conventional methods of Western medicine for treating Barton's fracture

  1. Traditional Chinese medicine treatment:

  1. In the early stage, focus on activating blood and removing blood stasis. The basic prescription is to add or subtract the Active Pain Relieving Decoction. For example, Angelica sinensis, white peony, Salvia miltiorrhiza, peach kernel, safflower, Dibizhu, bone-breaking, Luodeta, Chuanxuduan, Yanhusuo each 9 grams, Sangshen 12 grams. Tablets can be used for Huayu Huoxue Tablets, Qixing San, etc.

  2. In the middle stage, focus on harmonizing the blood and generating new ones. The basic treatment is mainly based on tablets, various types of tablets can be used, such as fracture tablets, fracture zi jin dan, etc. Decoction can be used for Xu Gu Huoxue Decoction, such as Angelica sinensis, white peony, major Rehmannia, Zelania leaf, Dibizhu, bone-breaking, Chuanxuduan, Luodeta, Yanhusuo each 9 grams, Chenpi, Zhishen each 6 grams, Jixueteng, Sangshen each 12 grams.

  3. In the later stage, focus on consolidating the foundation and invigorating the kidney. Health steps tiger hidden ball can be used, 5 grams each time, taken twice, or decoction can be used, such as Shengxue Buzhi Decoction with modification (Angelica sinensis, white peony, Szechuan aconite, dog spine, Eucommia ulmoides, Eucommia ulmoides, Du Zhong, raw and processed Rehmannia, Astragalus, Sangshen each 9 grams,络石藤15 grams, can also use Baizhen Decoction, Bu Zhong Yi Qi Decoction, etc.

  2. Drug Treatment:

  Levodopa and other traditional Chinese medicine such as fracture medicine tablets, strong bone and joint pills, Sanqi tablets, etc., all have certain effects.

  3. Surgical Treatment:

  Pull the injured wrist along the longitudinal axis for traction and countertraction. For those with minor fractures, push the displaced bone fragments towards the palm side and distal end to achieve satisfactory reduction, which can be fixed with a cast to keep the wrist in a neutral position. To prevent recurrence of displacement, avoid fixing it in a掌屈 position. For those who cannot maintain position with external fixation, surgical reduction can be performed, with internal fixation using Kirschner wires or screws. There is some difficulty in plate and screw fixation due to the passage of extensor tendons on the dorsal side.

 

Recommend: Carpal tunnel syndrome , Radial Tunnel Syndrome , Fracture of the upper third of the ulna combined with dislocation of the radius head , Radial and ulnar shaft fractures , Colles fracture , Tendinitis of the long head of the biceps brachii muscle

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