smith fractures

smith fractures in brief collected by me Alhassan Al Salem medical student at Najran university

1. Smith fracture Alhassan Mahdi Alsalem

2. Definition Smith fracture ( reverse Colle’s ) also known as  Goyrand fractures  in the French literature : It is fracture of distal radius and the distal fragments displaced anteriorly.

3. Epidemiology Smith fractures account for less than 3% of all fractures of the radius and ulna and have a bimodal distribution: young males (most common) and elderly females

4. Types Type I = extra-articular Type II = intra-articular Type III = fracture-dislocation.

5. Clinical features The patient presents with a wrist injury, but there is no dinner-fork deformity. Instead, there is a ‘garden spade’ deformity.

6. X-ray There is a fracture through the distal radial metaphysis; a lateral view shows that the distal fragment is displaced and tilted anteriorly – the opposite of a Colles ’ fracture.

7. The entire metaphysis can be fractured, or there can be an oblique fracture exiting at the dorsal or volar rim of the radius.

8. Treatment The fracture is reduced by traction, supination and extension of the wrist, and the forearm is immobilized in a cast for 6 weeks .

9. X-rays should be taken at 7–10 days to ensure the fracture has not slipped.

10. Unstable fractures should be fixed with percutaneous wires or a plate.