Smith's fracture

Smith's Fracture

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X-ray image of a Smith's fracture

A Smith's fracture, also known as a reverse Colles' fracture, is a fracture of the distal radius with volar (palmar) displacement of the fracture fragment. It is named after the Irish surgeon Robert William Smith, who first described it in 1847. This type of fracture is less common than the Colles' fracture, which involves dorsal displacement.

Anatomy

The radius is one of the two large bones of the forearm, the other being the ulna. The distal end of the radius is the part closest to the wrist. In a Smith's fracture, the fracture occurs at the distal end of the radius, and the broken fragment is displaced towards the palm of the hand.

Mechanism of Injury

Smith's fractures typically occur as a result of a fall onto a flexed wrist or a direct blow to the back of the wrist. This contrasts with a Colles' fracture, which usually results from a fall onto an extended wrist.

Clinical Presentation

Patients with a Smith's fracture often present with pain, swelling, and deformity of the wrist. The wrist may appear to be bent forward, and there may be tenderness over the distal radius.

Diagnosis

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Lateral view of a Smith's fracture

Diagnosis of a Smith's fracture is typically confirmed with radiographic imaging. The X-ray will show a fracture of the distal radius with volar displacement of the distal fragment.

Treatment

Treatment of a Smith's fracture depends on the severity and displacement of the fracture. Non-displaced fractures may be treated with immobilization in a cast. Displaced fractures often require reduction and may need surgical intervention, such as open reduction and internal fixation (ORIF).

Complications

Complications of Smith's fractures can include malunion, nonunion, and post-traumatic arthritis. There is also a risk of injury to the median nerve, which can lead to carpal tunnel syndrome.

Prognosis

The prognosis for a Smith's fracture is generally good with appropriate treatment. However, recovery may take several weeks to months, and physical therapy may be necessary to restore full function.

Related Pages

• Colles' fracture
• Distal radius fracture
• Wrist joint
• Orthopedic surgery