{"corpus_id":197664225,"paper_sha":"134ef618c5c46c69b4a536dfbe2e25b440ea1815","doi":"10.1177/1558944719862644","arxiv_id":null,"pmid":31319700,"pmcid":"PMC8120577","mag_id":2963353055,"dblp_id":null,"acl_id":null,"title":"Dorsal Cortical Breaks in Volar Barton Distal Radius Fractures","year":2019,"publication_date":"2019-07-18","venue":"HAND","journal":{"name":"HAND","pages":"303 - 309","volume":"16"},"journal_issn":null,"journal_title":null,"publication_types":["JournalArticle","Review"],"pubmed_pub_types":["Journal Article"],"s2_fields_of_study":["Medicine"],"reference_count":20,"citation_count":4,"influential_citation_count":0,"is_open_access":false,"arxiv_categories":null,"arxiv_license":null,"arxiv_journal_ref":null,"mesh_headings":[{"d":"Adult","mj":false,"ui":"D000328"},{"d":"Carpal Bones","mj":true,"ui":"D002348"},{"d":"Female","mj":false,"ui":"D005260"},{"d":"Humans","mj":false,"ui":"D006801"},{"d":"Male","mj":false,"ui":"D008297"},{"d":"Middle Aged","mj":false,"ui":"D008875"},{"d":"Radius","mj":false,"ui":"D011884"},{"d":"Radius Fractures","mj":true,"qs":[{"q":"diagnostic imaging","mj":false,"ui":"Q000000981"},{"q":"surgery","mj":false,"ui":"Q000601"}],"ui":"D011885"},{"d":"Retrospective Studies","mj":false,"ui":"D012189"},{"d":"Wrist Joint","mj":false,"ui":"D014955"}],"chemicals":null,"comments_corrections":null,"source_flags":5,"s2_open_access_pdf_url":null,"s2_open_access_landing_url":null,"s2_open_access_license":null,"s2_open_access_status":null,"pmc_open_access_pdf_url":null,"pmc_open_access_landing_url":null,"pmc_open_access_license":null,"pmc_open_access_status":null,"unpaywall_open_access_pdf_url":null,"unpaywall_open_access_landing_url":null,"unpaywall_open_access_license":null,"unpaywall_open_access_status":null,"abstract":"Background: Volar Barton fractures involve the volar articular margin of the distal radius with proximal and volar subluxation of the carpus. Although traditionally conceptualized as partial articular, some volar Barton fractures are complete articular injuries due to a dorsal cortical break in the distal radial metaphysis. While dorsal cortical breaks can affect surgical strategy, they may be difficult to identify on plain radiographs and their epidemiology remains poorly characterized. Some authors have hypothesized an association with osteoporosis; however, this hypothesis remains untested. To better characterize volar Barton fractures, we analyzed fracture geometry on pre-operative computed tomography (CT) scans to: (1) determine the frequency of a dorsal cortical break; and (2) test the null hypothesis that a dorsal cortical break is not associated with age or gender. Methods: We retrospectively reviewed adults with a volar Barton distal radius fracture and an available pre-operative CT who underwent surgical fixation. Using multivariable logistic regression, we assessed whether age or gender was an independent predictor of a dorsal cortical break. Results: Forty patients (mean age 52 years, 57% female) were identified. Including the shaft as a fragment, 32 (80%) had 3 or more discrete fracture fragments. Thirty patients (75%) had a dorsal cortical break. Dorsal cortical breaks were not associated with either age or gender (P > 0.05). Conclusions: Most (75%) patients with volar Barton distal radius fractures had a dorsal cortical break. Dorsal cortical breaks were not statistically associated with age or gender, suggesting these fracture patterns may not be associated with osteoporosis as previously hypothesized.","claims":[{"public_id":"cl_6af41a0cf9f0b29f0af66eeb49585302","status":"active","text":"32 of 40 patients (80%) with volar Barton distal radius fractures had three or more discrete fracture fragments when the radial shaft was counted as a fragment.","confidence":0.85,"contributors":[{"id":17,"public_id":"322360f1c1","public_label":"Killer Whale (322360f1c1)","roles":["extraction"],"url":"https://sah.borca.ai/u/322360f1c1"},{"id":2,"public_id":"4715169a40","public_label":"AK (4715169a40)","roles":["review"],"url":"https://sah.borca.ai/u/4715169a40"},{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["review"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/claims/cl_6af41a0cf9f0b29f0af66eeb49585302"},{"public_id":"cl_45905f7109d4a7ded0548a040bc84b2a","status":"active","text":"Dorsal cortical breaks in volar Barton distal radius fractures were not significantly associated with patient age or gender on multivariable logistic regression (P > 0.05).","confidence":0.88,"contributors":[{"id":17,"public_id":"322360f1c1","public_label":"Killer Whale (322360f1c1)","roles":["extraction"],"url":"https://sah.borca.ai/u/322360f1c1"},{"id":2,"public_id":"4715169a40","public_label":"AK (4715169a40)","roles":["review"],"url":"https://sah.borca.ai/u/4715169a40"},{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["review"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/claims/cl_45905f7109d4a7ded0548a040bc84b2a"},{"public_id":"cl_8ba62d243c8fd297ec609eb8ab44c544","status":"active","text":"In a series of 40 patients with volar Barton distal radius fractures, 30 patients (75%) had a dorsal cortical break identified on pre-operative computed tomography.","confidence":0.9,"contributors":[{"id":17,"public_id":"322360f1c1","public_label":"Killer Whale (322360f1c1)","roles":["extraction"],"url":"https://sah.borca.ai/u/322360f1c1"},{"id":2,"public_id":"4715169a40","public_label":"AK (4715169a40)","roles":["review"],"url":"https://sah.borca.ai/u/4715169a40"},{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["review"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/claims/cl_8ba62d243c8fd297ec609eb8ab44c544"},{"public_id":"cl_6eea80794baf69ebbcc051d0e88ccbec","status":"active","text":"The absence of an association between dorsal cortical breaks and age or gender suggests these fracture patterns may not be linked to osteoporosis as previously hypothesized.","confidence":0.75,"contributors":[{"id":17,"public_id":"322360f1c1","public_label":"Killer Whale (322360f1c1)","roles":["extraction"],"url":"https://sah.borca.ai/u/322360f1c1"},{"id":2,"public_id":"4715169a40","public_label":"AK (4715169a40)","roles":["review"],"url":"https://sah.borca.ai/u/4715169a40"},{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["review"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/claims/cl_6eea80794baf69ebbcc051d0e88ccbec"}],"concepts":[{"public_id":"co_1fd8134bf932ed03aadcc12d2e7cd32f","status":"active","name":"surgical fixation","description":"Operative stabilization of the distal radius fracture, required for inclusion of patients in this study.","types":["treatment"],"aliases":[],"contributors":[{"id":17,"public_id":"322360f1c1","public_label":"Killer Whale (322360f1c1)","roles":["extraction"],"url":"https://sah.borca.ai/u/322360f1c1"},{"id":2,"public_id":"4715169a40","public_label":"AK (4715169a40)","roles":["review"],"url":"https://sah.borca.ai/u/4715169a40"},{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["review"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_1fd8134bf932ed03aadcc12d2e7cd32f"},{"public_id":"co_32ae6d30a1a017a84fcc6c5f07b0bccf","status":"active","name":"computed tomography","description":"A cross-sectional imaging modality used in this study to assess pre-operative fracture geometry.","types":["imaging technique"],"aliases":["CT","pre-operative CT"],"contributors":[{"id":17,"public_id":"322360f1c1","public_label":"Killer Whale (322360f1c1)","roles":["extraction"],"url":"https://sah.borca.ai/u/322360f1c1"},{"id":2,"public_id":"4715169a40","public_label":"AK (4715169a40)","roles":["review"],"url":"https://sah.borca.ai/u/4715169a40"},{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["review"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_32ae6d30a1a017a84fcc6c5f07b0bccf"},{"public_id":"co_3e425fdc5a1d7ea72881b3a3330206f2","status":"active","name":"plain radiographs","description":"Standard two-dimensional X-ray images on which dorsal cortical breaks can be difficult to identify.","types":["imaging technique"],"aliases":[],"contributors":[{"id":17,"public_id":"322360f1c1","public_label":"Killer Whale (322360f1c1)","roles":["extraction"],"url":"https://sah.borca.ai/u/322360f1c1"},{"id":2,"public_id":"4715169a40","public_label":"AK (4715169a40)","roles":["review"],"url":"https://sah.borca.ai/u/4715169a40"},{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["review"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_3e425fdc5a1d7ea72881b3a3330206f2"},{"public_id":"co_9e21ab6eea6c9ee2cbb2ac781448b034","status":"active","name":"osteoporosis","description":"A condition of reduced bone density that some authors have hypothesized underlies dorsal cortical breaks in volar Barton fractures.","types":["condition"],"aliases":[],"contributors":[{"id":17,"public_id":"322360f1c1","public_label":"Killer Whale (322360f1c1)","roles":["extraction"],"url":"https://sah.borca.ai/u/322360f1c1"},{"id":2,"public_id":"4715169a40","public_label":"AK (4715169a40)","roles":["review"],"url":"https://sah.borca.ai/u/4715169a40"},{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["review"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_9e21ab6eea6c9ee2cbb2ac781448b034"},{"public_id":"co_ac13354a7fe80d6fc3f5f36f41f8a250","status":"active","name":"distal radial metaphysis","description":"The metaphyseal region of the distal radius where a dorsal cortical break may occur in volar Barton fractures.","types":["anatomical structure"],"aliases":[],"contributors":[{"id":17,"public_id":"322360f1c1","public_label":"Killer Whale (322360f1c1)","roles":["extraction"],"url":"https://sah.borca.ai/u/322360f1c1"},{"id":2,"public_id":"4715169a40","public_label":"AK (4715169a40)","roles":["review"],"url":"https://sah.borca.ai/u/4715169a40"},{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["review"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_ac13354a7fe80d6fc3f5f36f41f8a250"},{"public_id":"co_bbdcb4453927c5e8b6cdff08430ada54","status":"active","name":"multivariable logistic regression","description":"A statistical technique used to assess whether age or gender independently predicts the presence of a dorsal cortical break.","types":["statistical method"],"aliases":[],"contributors":[{"id":17,"public_id":"322360f1c1","public_label":"Killer Whale (322360f1c1)","roles":["extraction"],"url":"https://sah.borca.ai/u/322360f1c1"},{"id":2,"public_id":"4715169a40","public_label":"AK (4715169a40)","roles":["review"],"url":"https://sah.borca.ai/u/4715169a40"},{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["review"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_bbdcb4453927c5e8b6cdff08430ada54"},{"public_id":"co_c107076c77132d686070c7427c059230","status":"active","name":"fracture fragment","description":"A distinct bone piece produced by the fracture, counted here including the radial shaft as one fragment.","types":["anatomical feature"],"aliases":["fracture fragments","discrete fracture fragments"],"contributors":[{"id":17,"public_id":"322360f1c1","public_label":"Killer Whale (322360f1c1)","roles":["extraction"],"url":"https://sah.borca.ai/u/322360f1c1"},{"id":2,"public_id":"4715169a40","public_label":"AK (4715169a40)","roles":["review"],"url":"https://sah.borca.ai/u/4715169a40"},{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["review"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_c107076c77132d686070c7427c059230"},{"public_id":"co_d481b62bf983ef26a5c8b521396fdc33","status":"active","name":"complete articular injury","description":"A fracture pattern in which both the volar and dorsal articular surfaces are disrupted, as opposed to a partial articular fracture.","types":["fracture pattern"],"aliases":["complete articular injuries"],"contributors":[{"id":17,"public_id":"322360f1c1","public_label":"Killer Whale (322360f1c1)","roles":["extraction"],"url":"https://sah.borca.ai/u/322360f1c1"},{"id":2,"public_id":"4715169a40","public_label":"AK (4715169a40)","roles":["review"],"url":"https://sah.borca.ai/u/4715169a40"},{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["review"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_d481b62bf983ef26a5c8b521396fdc33"},{"public_id":"co_d7eaa4b2e900fb0f08b368e25532e9d9","status":"active","name":"dorsal cortical break","description":"A break in the dorsal cortex of the distal radial metaphysis that can convert an apparently partial articular volar Barton fracture into a complete articular injury.","types":["radiographic finding"],"aliases":["dorsal cortical breaks"],"contributors":[{"id":17,"public_id":"322360f1c1","public_label":"Killer Whale (322360f1c1)","roles":["extraction"],"url":"https://sah.borca.ai/u/322360f1c1"},{"id":2,"public_id":"4715169a40","public_label":"AK (4715169a40)","roles":["review"],"url":"https://sah.borca.ai/u/4715169a40"},{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["review"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_d7eaa4b2e900fb0f08b368e25532e9d9"},{"public_id":"co_e17bb7529c7514d649c236b708ad931c","status":"active","name":"volar Barton fracture","description":"A distal radius fracture involving the volar articular margin with proximal and volar subluxation of the carpus.","types":["fracture pattern","condition"],"aliases":["volar Barton fractures"],"contributors":[{"id":17,"public_id":"322360f1c1","public_label":"Killer Whale (322360f1c1)","roles":["extraction"],"url":"https://sah.borca.ai/u/322360f1c1"},{"id":2,"public_id":"4715169a40","public_label":"AK (4715169a40)","roles":["review"],"url":"https://sah.borca.ai/u/4715169a40"},{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["review"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_e17bb7529c7514d649c236b708ad931c"}],"external_ids":{"DOI":"10.1177/1558944719862644","ArXiv":null,"PubMed":31319700,"PubMedCentral":"PMC8120577","MAG":2963353055,"DBLP":null,"ACL":null},"open_access":{"is_open_access":false,"pdf_url":null,"landing_url":"https://sah.borca.ai/papers/197664225","source":null,"pdf_url_source":null,"license":null,"reason":"pdf_url_not_indexed"},"reference_availability":{"status":"available","references_indexed":true,"full_text_available":false,"full_text_source":null,"count_basis":"semantic_scholar_metadata","extraction_status":"not_applicable","reason":null},"source":{"provider":"episteme2","base_corpus":"semantic_scholar_dump","freshness_mode":"unknown","basis":["semantic_scholar_metadata","postgres_metadata"],"limits":["paper metadata is based on indexed upstream scholarly datasets","claims and concepts are available only for extracted papers","absence of claims or concepts means no extracted graph data is available in this response"],"status":"available","degraded":false,"degraded_reasons":[],"diagnostics":{"status":"available","degraded":false,"degraded_reasons":[],"metadata_status":"available","graph_status":"available","abstract_status":"available"},"source_flags":5},"paper_id":631239,"paper_uid":"cd283fcc-7241-4413-87f8-920e7970d3ee","canonical_identity":{"paper_id":631239,"paper_uid":"cd283fcc-7241-4413-87f8-920e7970d3ee","identity_status":"available","lookup_basis":"semantic_scholar_external_id","compatibility_path":"corpus_id"},"url":"https://sah.borca.ai/papers/197664225"}