Difference between revisions of "Smith's fracture"

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==Background==
 
==Background==
*Volar angulated fracture ("reverse Colles fracture" or "garden-spade deformity")
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*Also known as a reverse Colles' fracture or Goyrand-Smith's
*Occurs due to fall onto the dorsum of the hand with wrist in flexion, or direct blow to dorsum of hand/wrist
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*Volar angulated fracture of distal radius ("reverse Colles fracture" or "garden-spade deformity")
  
 
==Clinical Features==
 
==Clinical Features==
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*Mechanism: fall onto the dorsum of the hand with wrist in flexion, or direct blow to dorsum of hand/wrist<ref name="Hand and wrist emergencies">German C. Hand and wrist emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.</ref>
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*Wrist pain
  
 
==Differential Diagnosis==
 
==Differential Diagnosis==
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==Evaluation==
 
==Evaluation==
*X-ray forearm/wrist
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*Assess distal pulse, motor, and sensation
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*Inspect skin for any signs of open fracture
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*XRay
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**AP/Lateral of wrist and forearm
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*If intraarticular, may need CT for surgical planning
  
 
==Management==
 
==Management==
 
*[[Sugar tong splint]] in supination<ref name="Hand and wrist emergencies">German C. Hand and wrist emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.</ref>
 
*[[Sugar tong splint]] in supination<ref name="Hand and wrist emergencies">German C. Hand and wrist emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.</ref>
 
**Similar to [[Colles' fracture]]
 
**Similar to [[Colles' fracture]]
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*Typically unstable and requires surgical fixation
  
 
==Disposition==
 
==Disposition==
*Outpatient
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*Outpatient with Ortho follow-up
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==Complications==
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*Malunion can result in chronic garden spade deformity
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**Can also lead to [[Carpal tunnel syndrome]]
  
 
==See Also==
 
==See Also==
 
*[[Distal radius fractures]]
 
*[[Distal radius fractures]]
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==External Links==
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*https://radiopaedia.org/articles/smith-fracture
  
 
==References==
 
==References==
 
<references/>
 
<references/>
*German C. Hand and wrist emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013. 
 
 
  
 
[[Category:Orthopedics]]
 
[[Category:Orthopedics]]

Latest revision as of 17:06, 27 March 2018

Background

  • Also known as a reverse Colles' fracture or Goyrand-Smith's
  • Volar angulated fracture of distal radius ("reverse Colles fracture" or "garden-spade deformity")

Clinical Features

  • Mechanism: fall onto the dorsum of the hand with wrist in flexion, or direct blow to dorsum of hand/wrist[1]
  • Wrist pain

Differential Diagnosis

Distal radius fractures

Distal radius fracture eponyms

Eponyms Description
Barton's Fracture-dislocation of radiocarpal joint (with intra-articular fracture involving the volar or dorsal lip)
Chauffer's Fracture of radial styloid
Colles' Dorsally displaced, extra-articular fracture
Die-punch Depressed fracture of the lunate fossa (articular surface)
Smith's Volar displaced, extra-articular fracture

Evaluation

  • Assess distal pulse, motor, and sensation
  • Inspect skin for any signs of open fracture
  • XRay
    • AP/Lateral of wrist and forearm
  • If intraarticular, may need CT for surgical planning

Management

Disposition

  • Outpatient with Ortho follow-up

Complications

See Also

External Links

References

  1. 1.0 1.1 German C. Hand and wrist emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.