SURGICAL-TREATMENT OF 35 VOLAR BARTON FRACTURES - NO NEED FOR ROUTINEDECOMPRESSION OF THE MEDIAN NERVE

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