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Colles fracture vs Smith fracture



Colles fracture vs Smith fracture

Colles fracture

  • Definition
    Fracture of the distal radius with dorsal (posterior) displacement and angulation of the distal fragment.

  • Mechanism of injury
    Fall on an outstretched hand with the wrist in extension.

  • Deformity
    Classic “dinner-fork” or “silver-fork” deformity due to dorsal tilt.

  • Common patient group
    Elderly patients, especially postmenopausal women with osteoporosis.

  • Associated features
    Radial shortening, dorsal comminution, possible ulnar styloid fracture.

Smith fracture

  • Definition
    Fracture of the distal radius with volar (palmar) displacement and angulation of the distal fragment.

  • Mechanism of injury
    Fall on the back of the hand or fall with the wrist in flexion.

  • Deformity
    “Garden-spade” deformity due to volar tilt.

  • Common patient group
    Less common than Colles, seen in younger patients or high-energy trauma.

  • Associated features
    Greater instability and higher risk of complications compared to Colles fracture.

Key differences at a glance

FeatureColles fractureSmith fracture
Direction of displacementDorsalVolar
Wrist position at injuryExtensionFlexion
DeformityDinner-forkGarden-spade
FrequencyCommonRare
StabilityRelatively stableMore unstable

Why Smith fracture is considered more dangerous

Smith fractures have a higher tendency for displacement, malunion, and neurovascular complications because the volar cortex is weaker and harder to stabilize.


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