T&O: Smiths and Colles

Question 1

Define a Smiths fracture

Answer 1

Fracture of the distal radius with palmar angulation of the distal fracture fragments. Have volar (anterior) displacement of the distal fragment of the radius. AKA a reverse Colles fracture. Usually occurs on fall on back of flexed wrist

Question 2

Define a Colles fracture

Answer 2

Extra-articular distal radius fracture with dorsal angulation and dorsal displacement. Within 2cm of articular surface.

Question 3

Describe presentation (Hx and examination) of Colles fracture

Answer 3

Hx of trauma, FOOSH. Immediate pain, tenderness, swelling, bruising. Elderly woman or young adult. PMH of osteoporosis, post menopause. Dinner fork deformity. Unable to grasp object. Increased angulation of distal radius.

Question 4

What management options are available for fractures of the distal radius?

Answer 4

Reduction - external and/or internal fixation, percutaneous pinning, bone substitiutes. Immobilisation. Physiotherapy to restore range of movement, motion and function.

Question 5

What are the risk factors for Smiths or Colles fractures?

Answer 5

Age (older than 60 increases risk), being female, osteoporosis, menopause, smoking, alcohol use, prolonged steroid use.