Smith's fracture

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.