Smith's fracture: Difference between revisions

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==Background==
==Background==
*Volar angulated fx ("reverse Colles fracture" or "garden-spade deformity")
*Also known as a reverse Colles' fracture or Goyrand-Smith's
*Occurs due to fall or direct blow to dorsum of hand/wrist
*Volar angulated fracture of distal radius ("reverse Colles fracture" or "garden-spade deformity")


==Imaging==
==Clinical Features==
*Similar but opposite to [[Colles' fracture]]
*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>
*Wrist pain


==Differential Diagnosis==
==Differential Diagnosis==
{{Distal radius fracture DDX}}
{{Distal radius fracture DDX}}
==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==
==Management==
*Similar to [[Colles' fracture]]
{{General Fracture Management}}
*[[sugar tong splint]]
 
===Immobilization===
*[[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]]
*Typically unstable and requires surgical fixation
 
==Disposition==
*Outpatient with Ortho follow-up
 
==Complications==
*Malunion can result in chronic garden spade deformity
**Can also lead to [[Carpal tunnel syndrome]]  


==See Also==
==See Also==
*[[Distal radius fractures]]
*[[Distal radius fractures]]


==Source==
==External Links==
*Tintinalli
*https://radiopaedia.org/articles/smith-fracture
 
==References==
<references/>


[[Category:Orthopedics]]
[[Category:Orthopedics]]

Latest revision as of 04:27, 18 September 2019

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

General Fracture Management

Immobilization

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.