Makindo Medical Notes"One small step for man, one large step for Makindo" |
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Related Subjects: |Shoulder Anterior Dislocations |Shoulder:Posterior Dislocation |Elbow Dislocation |Olecranon Fracture |Distal Humerus Fracture |Radial Head and Neck Fractures |Forearm Fractures |Shaft of Ulna Fracture |Wrist Colles Fracture |Wrist Smith’s Fracture
| Feature | Colles’ Fracture 🖐️ | Smith’s Fracture 🔄 | Barton’s Fracture ⚙️ |
|---|---|---|---|
| Type / Location | Extra-articular fracture of distal radius with dorsal angulation. | Extra-articular fracture of distal radius with volar (palmar) angulation. | Intra-articular fracture of distal radius with volar displacement of the carpus and distal fragment. |
| Mechanism of Injury | Fall on an outstretched hand (FOOSH) with wrist in extension. | Fall onto a flexed wrist. | Usually high-energy fall or trauma to the wrist in flexion with joint involvement. |
| Typical Deformity | “Dinner-fork” deformity (dorsal displacement of wrist and hand). | “Garden-spade” deformity (volar displacement of wrist and hand). | Often subtle deformity but radiocarpal instability present. |
| Pain & Swelling | Over distal radius; worsens with wrist movement. | Over distal radius; worsens with wrist movement. | Over wrist and radiocarpal joint line; significant tenderness. |
| Neurological / Vascular | Assess median nerve (thumb, index sensation) and pulses. | Assess median nerve (thenar motor) and vascular status. | Check both median and ulnar nerves; assess perfusion. |
| X-Ray Findings | Dorsal displacement and angulation of distal fragment. | Volar displacement and angulation of distal fragment. | Intra-articular fracture with volar displacement of carpus and distal radius fragment. |
| Stability | Usually stable after reduction. | More unstable than Colles’. | Highly unstable; always involves the joint. |
| Initial Management | Closed reduction + Colles’ backslab or below-elbow cast. | Immobilise in Colles’ backslab; urgent ortho review. | Immediate orthopaedic referral for likely surgery. |
| Definitive Treatment | Conservative if alignment acceptable; otherwise ORIF. | Often requires ORIF with volar plate fixation. | Almost always needs ORIF for joint surface restoration. |
| Mnemonic Summary | 👉 Colles = Dorsal, Extra-articular | 👉 Smith = Volar, Extra-articular | 👉 Barton = Volar, Intra-articular |