Smith vs Colles Fracture
Smith and Colles fractures are two types of fractures that occur in the wrist. Both fractures involve the radius bone, which is one of the two bones in the forearm that connect to the wrist. However, they differ in the direction of the fracture and the mechanism of injury.
A Smith fracture, also known as a reverse Colles fracture, occurs when the wrist is flexed forcefully, causing the distal end of the radius bone to break and move towards the palm of the hand. This type of fracture is more common in younger individuals and is often caused by a fall on an outstretched hand or a direct blow to the back of the wrist. Symptoms of a Smith fracture include pain, swelling, and difficulty moving the wrist.
On the other hand, a Colles fracture occurs when the wrist is extended forcefully, causing the distal end of the radius bone to break and move towards the back of the hand. This type of fracture is more common in older individuals and is often caused by a fall on an outstretched hand. Symptoms of a Colles fracture include pain, swelling, and a visible deformity in the wrist.
Treatment for both Smith and Colles fractures typically involves immobilizing the wrist with a cast or splint to allow the bone to heal. In some cases, surgery may be necessary to realign the bone fragments and stabilize the wrist. Physical therapy may also be recommended to help restore range of motion and strength in the wrist.
In summary, Smith and Colles fractures are two types of fractures that occur in the wrist. While both involve the radius bone, they differ in the direction of the fracture and the mechanism of injury. Treatment for both fractures typically involves immobilization and may require surgery or physical therapy.
Smith vs Colles Fracture
Several types of wrist fractures exist. Two of these are Smith and Colles fractures. You need to understand what they are and the treatment options available for both. Here is a review of the Smith and Colles fractures.
Contents
1 -What Are Smith and Colles Fractures?
2- Symptoms of Smith and Colles Fractures
3 -Diagnosis of Smith and Colles Fractures
4 -Treatment of Smith Fracture
5 -Treatment of Colles Fracture
6 -Can Other Conditions Develop if Treatment is Delayed?
7- Pain Management of Smith and Colles Fractures
8 -Outlook of Smith and Colles Fractures
What Are Smith and Colles Fractures?
A Smith fracture occurs on the distal radius. This is the larger radius in the two bones in the arm. A Smith fracture is also associated with palmar angulation of the distal fragment. Smith fractures do not extend to the wrist, hence they are extra-articular. These fractures are usually transverse. Smith fractures are rare and are most often seen in elderly women or young men.
A Colles fracture is a broken wrist. It occurs when the radius is broken. When the bone breaks 1 inch from the wrist, it’s called a distal radius break. The broken bone in the fracture usually points upward. It’s the most common fracture, and it generally occurs when you fall over an outstretched arm. The fracture is common among those between the ages of 18 and 25. For older adults, the fracture occurs due to falling when their bones are brittle.
So What is the difference between a Smith fracture and other wrist fractures?
The type of wrist fracture you have depends on how your bones broke and what the break itself looks like. Smith fractures usually come from falling with your wrist closed or flexed inward, or from a direct blow to the back of your hand.
Smith fracture vs. Colles fracture
If you’re diagnosed with a Colles fracture, the broken piece of your wrist bone (radius) points backward. Smith fractures are the opposite: The broken end of your bone points forward.
Smith fracture vs. Barton fracture
Barton fractures are similar to Smith fractures — they both usually come from falling on your wrist when it’s closed or flexed in. But with Barton fractures, your broken bones angle up or away from your palm.
Symptoms of Smith and Colles Fractures
Both fractures have similar symptoms. You will experience immediate pain, bruising, and swelling in the area and tenderness in the surrounding tissue. Depending on the severity of the fracture, the wrist might be in an unnatural position.
Diagnosis of Smith and Colles Fractures
For Smith fractures, the pain is not very severe, and you still have a functioning wrist. You can do first aid and visit the doctor after a while. If you experience some numbness or have pink fingers, or your wrist is at an abnormal angle, you need to rush to the emergency room.
The same applies to Colles fractures. If the pain feels unbearable and you cannot use the hand normally, you need to go to the emergency room. Once you get there, the doctor will do a physical examination and ask how you feel and what you observed. You can have an X-ray done to see the severity of the fracture before you start discussing treatment options. An orthopedist will then treat you.
Treatment of Smith Fracture
Smith fractures are treated by putting the broken bones together in the correct order. There is a need to ensure that the bones remain in place until the injury heals. Treatment varies depending on your age and the extent of the injury. There are surgical and non-surgical treatment options.
For non-surgical treatment, the doctor will perform a closed reduction, which puts the bones back together. After this, the bones will be held in place with a splint or cast. At first, you might use a splint to allow for swelling to go up and down, and then you’ll get a cast.
If the bones are out of place and closed reduction is impossible, an incision will be made to align the bones. The physician can use a few things to hold the bones together, such as a cast, plates, screws, and metal pins.
Treatment of Colles Fracture
Treatment of Coles fractures can be through the use of surgical and non-surgical methods.
For non-surgical treatment, the bones will be aligned and a cast or splint used to keep the bones in place. Splints are used for less active people, while casts are used for those who engage in several activities. The healing process will be monitored over six weeks.
Closed reduction is the option when non-invasive treatment is involved. If the injury is severe, the physician can decide to use open reduction to align the bones. A small incision is made and the bones are aligned and held in place using a cast, plates, metal pins, screws, or external fixators, or a combination.
Can Other Conditions Develop if Treatment is Delayed?
If you delay treatment or do not get proper treatment, your bones will not heal properly. You will not regain the full function of your hand. You can also get complex regional pain syndrome that affects your limbs after injury. It’s believed that the syndrome occurs when the nervous system gets damaged. If you experience pain after an injury, you need to inform your physician so they can check for any additional damage.
Pain Management of Smith and Colles Fractures
The pain you experience when you have a fracture is difficult to determine. If the pain is moderate, you can use ice packs and OTC painkillers and elevate the arm. To get relief from pain and inflammation, you might be given acetaminophen and ibuprofen. Severe pain might have you getting an opioid prescription.
Outlook of Smith and Colles Fractures
When the cast is on, you need to keep it dry. Most people who get Smith or Colles fractures have a full recovery. However, there are some guidelines to promote full recovery.
Fractures usually heal after about six weeks but might take longer if the injury was severe. Full recovery can take as long as a year.
You might need physical therapy and rehabilitation to get the arm back to functioning. It also helps to boost the energy of the limb. It’s advisable to do light activities for at least two months after treatment.
You might experience some stiffness before the hand recovers fully. Depending on the severity of the fracture, this can last up to two years.
Getting a fracture doesn’t mean it’s the end of the road. You can still resume your favorite activities once you fully recover from your fracture. Most people get Colles fractures as opposed to Smith fractures. Smith fractures are usually not as severe as Colles fractures but should still be checked out by a specialist. In case you get a wrist injury, you need to understand when to take pain relief medication and when to seek medical attention to prevent any complications from arising.
How long does it take a Smith fracture to heal?
Healing time depends on the severity of your fracture and which treatments you needed. It can take anywhere from a few months to more than a year to recover.
Splinting and casting: Around six weeks.
Closed reduction: You’ll be able to go home the same day you have the procedure and will need a splint/cast for at least six to eight weeks if you don’t need surgery.
Surgery: It’ll take between one and three months to recover from surgery. You’ll also need four to six weeks of rehab.
Many people will experience stiffness and pain in their wrist that can last for months or even years after their fracture heals.
When can I go back to work/school?
Regardless of which kind of treatment you need, a Smith fracture will impact your life while you heal:
It may be hard to read, write or use a computer, especially if you broke the wrist on your dominant side.
If you had surgery, you’ll need physical therapy before regaining your strength.
Even if you don’t need surgery, your healthcare provider will give you an exercise routine to help you maintain your hand and wrist’s range of motion and flexibility.
Your healthcare provider will also help you understand how long you’ll need to miss work, school or other activities while you heal.
Most people can return to light exercise (walking, jogging, lower body workouts) a month or two after having their cast removed or after surgery. It can take as long as six months before you’re able to resume intense activity like heavy workouts or contact sports, though.
What are complications of Smith fractures?
Smith fracture complications can include:
Acute compartment syndrome (ACS): A build-up of pressure in your muscles may stop blood from getting to tissue, which can cause permanent muscle and nerve damage.
Malunion: This happens when your broken bones don’t line up correctly while they heal.
Carpal tunnel syndrome: A broken wrist that doesn’t heal properly may lead to carpal tunnel syndrome, which causes pain, numbness and weakness in the affected hand.
Bone infection (osteomyelitis): If you have an open wrist fracture (the bone breaks through your skin), you have an increased risk of bacterial infection.
Other internal damage: Fractures can damage the area around your injury, including your muscles, nerves, blood vessels, tendons and ligaments.
When should I see my healthcare provider or go to the emergency room?
If you think you have a wrist fracture, get help right away. Go to the emergency room if you’ve experienced a trauma and have any of the following symptoms:
Intense pain.
Swelling.
Tenderness.
You can’t move your wrist.
Make sure you tell your healthcare provider or the emergency responders everything that happened.
What questions should I ask my healthcare provider?
What kind of fracture do I have?
Will I need to wear a splint or cast?
Do I need surgery?
Will I require physical therapy?
How soon can I use my broken wrist?
When can I play sports or work out?
When will my wrist be completely healed?
A note from professor Mohammed Hutaif
Breaking a bone is always scary, especially if it happens during a traumatic event. Fortunately, wrist fractures are treatable, and most people are able to resume all the activities they enjoyed before their injury. If you think you have a Smith fracture, or any other kind of broken wrist, get it examined as soon as possible. If you have specific risk factors like osteoporosis, make sure you talk to your healthcare provider about how you can keep your bones strong to prevent fractures.