Smith's fracture

This is a fracture of the distal radius which occurs if the patient lands with the wrist in flexion. The radial fragment is displaced anteriorly and the fracture does not extend into the joint (cf. Barton's fracture). A Smith fracture produces what is known as an "inverse dinner fork deformity."

The fracture is readily seen on x-ray. A lateral view shows the fragment to be displaced and tilted anteriorly - the opposite of a Colles’ fracture. This and the fact that Smith was Colles' successor as Professor of Surgery in Dublin explains why the condition may often be referred to as a reverse Colles' fracture.

Treatment is by closed manipulation and splinting. A forearm cast is applied with the hand supine and the wrist fully extended. Immobilisation is usually for a period of six weeks.

Reference

1. Shah HM, Chung KC. Robert William Smith: his life and his contributions to medicine. J Hand Surg Am. 2008 Jul-Aug;33(6):948-51.