# Comparison of treatment of volar Barton’s fracture with T plate using distal end screws and without distal end screws

## TL;DR

This study compares two surgical methods for treating volar Barton’s fractures and finds similar clinical outcomes but better callus formation with one method.

## Contribution

The study provides empirical evidence comparing T-plate fixation with and without distal end screws for volar Barton’s fractures.

## Key findings

- Both treatment groups showed comparable clinical outcomes and fracture healing at 90 days.
- Callus formation was significantly better in the group without distal end screws.
- Stewart scores and Stewart displacement outcomes were similar between the two groups.

## Abstract

To compare the functional and radiological outcomes of treatment of volar Barton’s fractures using T plate with and without distal end screws.

This randomized control trial was conducted at the department of Orthopedics, Mayo Hospital, Lahore, Pakistan from December 2021 to May 2022. Total 60 patients (30 in each group) were randomly allocated to either group A (T-Plate with distal end screws) or B (T-Plate without distal end screws). Patients were followed up on day-0, day-14, day-28 and day-90. Assessments of patients were done by Green O’Brien Score for pain, Modified Warden Score for callus formation on radiographs at 12-weeks of follow-up and Stewart Score for displacement of fracture.

At 90th day, significant difference was seen in Green O’Brien Score (Excellent score: Group-A: 80% vs. Group-B: 90%, p=0.278) while Stewart scores remained comparable (Excellent Score: Group-A: 93.33% vs. Group-B: 96.67%, p=0.221) between treatment groups. Fracture healing assessed with Modified Warden score for score 4 did not show significant difference between both groups at 90th day. i.e. (Group-A: 96.67% vs. Group-B: 96.67%). However, callus formation assessed with Modified Warden score for score 3 showed significant differences between groups at 90th day. i.e. (Group-A: 53.33% vs. Group-B: 86.67%, p=0.001).

Both treatment approaches appear to yield comparable outcomes in terms of clinical assessment, Stewart scores, and fracture healing, with a potential advantage for T-plate without distal end screw in callus formation at the 90th day.

Trial registration: IRCT20221231056999N1.