Named by Robert William Smith (1807-1873) who was a surgeon in Dublin, Ireland. History and etymologyįirst named for Jean-Gaspard-Blaise Goyrand, French physician (1746-1814) 4. More importantly, it also narrows and distorts the entry to the carpal tunnel and can result in carpal tunnel syndrome 1. Malunion, with a residual volar displacement of the distal radius results in a cosmetic deformity, referred to as a garden spade deformity. If the fracture can be reduced but remains unstable, or cannot be reduced then operative fixation ( ORIF) is usually required 1. In most cases, these fractures can be treated with closed reduction and cast application 1. Treatment depends on the type of fracture, stability and ability to successfully reduce the fracture. assess articulation of radio-lunate and radio-scaphoid joint.ensure no carpal malalignment or fractures are present.location (extra-, juxta- or intra-articular).In addition to reporting the presence of a distal radial fracture with volar angulation a number of features should be sought and commented upon: In intra-articular fractures (type II) the degree of articular step-off and gap should be assessed, and this may require CT. The fracture line is usually evident, although in undisplaced or mildly impacted fractures it can be difficult to see and subtle cortical breaches/buckling should be sought. In most instances, a plain wrist radiographic series will suffice for diagnosis and characterization. equivalent to a reverse Barton fracture.extra-articular transverse fracture through the distal radius.The fracture can be split into three types, although in practice a description suffices 1,2: Smith fractures usually occur in one of two ways: It was initially called a Chauffeur’s fracture because when the chauffeur would turn the crank to start the car, the motor often would cause the crank handle to jerk back.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 1. This fracture is classified as an articular fracture. These are often overlooked and not part of the classification system.Ī Chauffeur’s fracture is also known as a radial styloid fracture or a Hutchinson’s fracture. A Barton’s fracture can be described as volar (more common) or dorsal (less common).Ī die punch fracture is a depression fracture of the lunate fossa of the distal radius fracture that occurs with a vertical load through the lunate. This is an intra-articular fracture and is associated with a dislocation of the radio-carpal joint. These types of fractures are caused by falling backward and an outstretched arm.Īnother type of distal radius fracture is a Barton’s fracture. This is also an extra-articular fracture that is volarly displaced. These fractures occur from a fall forward on an outstretched hand.Ī reverse Colles fracture is also known as Smith’s fracture. A Colles fracture is an extra-articular fracture with a dorsal displacement. Many fractures are named based on their fracture location, fracture pattern, and type of displacement.Ĭolles fractures are the most common type of distal radius fracture and account for about 90% of distal radius fractures. Similarly, Intra-articular fractures can be displaced or nondisplaced but occur within the joint.
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