What is a Smith Fracture?
A Smith fracture is a severe wrist injury which can occur following a traumatic accident. The wrist is a delicate network of small bones which all have to work together to provide proper mobility and function to the forearm. Two of these bones are the radius and the ulna. One type of fracture involving these bones is termed a Smith fracture. Also called a Goyrand fracture, this injury takes place when the end of the radius has been broken. The bone fragments are also angulated slightly out of position. In this type of injury, the fragments of the bone are typically pointing in the direction of the palm.
The Mechanism of a Smith Fracture
A Smith fracture can take place in multiple ways, however, two mechanisms are most common. These include:
- A Fall Onto a Flexed Wrist: When people flex their wrist, they often curl their fingers and make a fist. If someone tries to brace a fall using a flexed wrist (such as a fist), the force of the impact may lead to a Smith fracture.
- A Direct Blow to the Back of the Wrist: Think about someone who is struck by an object or who sustains this impact in an auto accident. A direct blow to the back of the wrist will force the bone fragments in the opposite direction, fracturing toward the palm of the hand.
The groups of people most commonly affected by these injuries are young males and elderly females. If someone presents to the doctor with wrist pain following an accident, the next step is to make the proper diagnosis.
Diagnosis this Wrist Injury: Imaging is Needed
If someone visits the doctor with wrist pain after an accident, the suspicion of a bone fracture will likely be high. The doctor is going to test the motor function and sensation in the wrist and forearm, trying to isolate the break. After a thorough physical exam, the doctor will probably order an x-ray and look for specific signs of a fracture. The physician will:
- Look for a fracture line in the radius.
- Measure the degree of angulation away from the shaft of the radius.
- Measure the degree of displacement from its proper anatomic location.
- Look for possible associated injuries involving the bones of the hand, such as the lunate and the scaphoid.
Because the radius joins the lunate and scaphoid, these two bones may also be injured. All of this information will be important in planning the treatment process. Some individuals may require surgical correction.
The Treatment of this Fracture
Because the bone fragments are typically angulated toward the palm, some degree of reduction is generally needed. A trained orthopedic surgeon may try to perform a closed reduction first. In this procedure, the patient will be sedated, and the surgeon will try to move the fragments back into place without using surgery. After the reduction, the surgeon will take an x-ray to assess whether or not the bones have been moved back into position.
If the surgeon is unable to perform a closed reduction, surgery will be needed. In this procedure, the surgeon will open up the wrist and use plates and screws to put the radius back together. Following the reduction, the wrist will be placed in a cast for several weeks while the fragments heal.
Most people make a full recovery following a Smith fracture. There have been reports of individuals suffering from carpal tunnel syndrome following this injury. To avoid this, a proper union of the bone fragments is vital.
Watch YouTube Video: Smith’s Fracture. This animated video provides an overview of a Smith’s fracture, the cause, symptoms, and treatment.
Sacramento Personal Injury Lawyer
I’m Ed Smith, a Sacramento personal injury lawyer. A Smith fracture is a wrist injury which can lead to serious complications. If someone you know has developed complications after a wrist injury due to the negligence of another person, please call me today at (916) 921-6400 or (800) 404-5400 for free, friendly legal advice.
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