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Smiths Fracture

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Other Names

  • Reverse Colles' Fracture
  • Goyrand-Smith's Fracture
  • Goyrand Fracture
  • Garden-spade deformity

Background

  • Fracture of the distal Radius with associated volar angulation of the fracture fragment

Pathophysiology

  • Etiology:
    • Fall on flexed wrist (not FOOSH)
    • Direct trauma to the back of the wrist
  • Less than 3% of all radius fractures (need citation)
  • Bimodal, young males and elderly females

Risk Factors


Differential Diagnosis

Distal Radius Fractures

Differential Diagnosis Wrist Pain


Clinical Features


Evaluation

Radiographs

CT scan

  • Important to evaluate intra-articular component

MRI

  • Evaluate for soft tissue injuries

Classification

  • Type I: extra articular
  • Type II: crosses into the dorsal articlar surface
  • Type III: enters radiocarpal joint
    • Equivalent to a reverse Barton's fracture

Management

Nonoperative

  • Most cases can be managed nonoperatively if extraarticular and closed reduction approaches near anatomic positioning
  • Splint: Sugar Tong Splint
  • Cast: Long Arm Cast

Operative

  • Indications
    • Open
    • Unstable
    • Unable to achieve anatomic closed reduction
    • Intra-articualr (type II, III)

Return to Play

  • Nonoperative will require at least 6 weeks
  • Surgically managed cases at the discretion of the surgeon

Complications


See Also


References

Created by:
John Kiel on 4 July 2019 07:02:20
Authors:
Last edited:
13 October 2022 21:39:50
Categories:
Trauma | Osteology | Wrist | Forearm | Upper Extremity | Fractures | Acute