Difference Between Colles and Smith Fracture Mnemonic

Fractures of the distal radius are common, particularly among the elderly and those who engage in high-risk activities. Two specific types of distal radius fractures that are often discussed in medical literature and practice are Colles fractures and Smith fractures. To aid in the differentiation between these two fractures, mnemonics can be a useful tool for medical students, healthcare providers.

Comparison Table

Below is the difference between Colles Fractur and Smith Fracture in a tabular format:

Feature Colles Fracture Smith Fracture
Mechanism of Injury Fall on an outstretched hand (FOOSH) Fall on a flexed wrist
Deformity Dinner fork or silver fork deformity Garden spade deformity
Displacement Dorsal displacement of distal fragment Volar displacement of distal fragment
Common Patient Demographic Elderly, particularly women with osteoporosis Younger patients, often due to high-impact trauma
Radiographic Appearance Dorsal angulation, radial shortening Volar angulation, no radial shortening
Typical Treatment Closed reduction and casting, sometimes surgery Closed reduction and casting, sometimes surgery

Browse best Scrubs Collection

What is Colles Fracture?

A Colles fracture, named after Abraham Colles who first described it in 1814, is one of the most common fractures of the distal radius. It typically occurs when a person falls onto an outstretched hand (FOOSH) with the wrist in extension. The hallmark of a Colles fracture is the dorsal displacement of the distal fracture fragment.

Mnemonic for Colles Fracture

These mnemonics help recall key points about the fractures, such as their mechanisms, clinical presentations, and radiographic appearances.

  • C: Common
  • O: Outstretched hand (fall on outstretched hand)
  • L: Lateral view shows dorsal displacement
  • L: Look for dinner fork deformity
  • E: Extension injury
  • S: Silver fork deformity

Symptoms of Colles Fracture

Patients with a Colles fracture usually present with:

  • Pain and swelling around the wrist
  • Visible deformity, often described as a "dinner fork" deformity due to the dorsal displacement
  • Limited range of motion
  • Bruising around the injured area

Diagnosis

Diagnosis is primarily made through physical examination and confirmed with X-rays, which reveal the characteristic dorsal displacement of the distal fragment.

Treatment

Treatment options for a Colles fracture include:

  • Non-surgical: Closed reduction followed by immobilization in a cast or splint. This approach is typically used for non-displaced or minimally displaced fractures.
  • Surgical: Open reduction and internal fixation (ORIF) with plates and screws, particularly for displaced or unstable fractures.

Prognosis

The prognosis for a Colles fracture is generally good, especially with appropriate treatment. However, complications such as stiffness, nerve injury, and post-traumatic arthritis can occur.

 

 

What is Smith Fracture?

Smith Fracture is a type of broken wrist, or fracture of the distal radius, that occurs when the wrist is bent or flexed during a fall or other trauma. This forces the wrist into flexion, causing the distal fragment to displace volarly. This is also known as a reverse Colles fracture, involving a volar displacement of the wrist and hand.

Mnemonic for Smith Fracture

  • S: Smith
  • M: Mechanism is fall on flexed wrist
  • I: Inward (volar/palmar displacement)
  • T: Transverse fracture line
  • H: Handlebar injury (common in bicyclists)

Symptoms

Patients with a Smith fracture typically exhibit:

  • Pain and swelling on the volar side of the wrist
  • Deformity, though less pronounced than in Colles fractures, with the hand displaced palmarly
  • Difficulty in wrist and finger movements
  • Tenderness over the distal radius

Diagnosis

Similar to Colles fractures, diagnosis is made through physical examination and confirmed by X-rays, which show the volar displacement of the distal fragment.

Treatment

Treatment approaches for Smith fractures include:

  • Non-surgical: Closed reduction and immobilization in a cast or splint, often used for non-displaced fractures.
  • Surgical: ORIF with plates and screws, especially for displaced, unstable, or intra-articular fractures.

Prognosis

The prognosis for a Smith fracture is also favorable with proper treatment. However, there is a higher risk of complications such as malunion, carpal tunnel syndrome, and post-traumatic arthritis.

Shop the Best Lab Coats from Here!

FAQ's

How are Colles and Smith fractures diagnosed?

Physical Examination for Assessing pain, swelling, deformity, and range of motion and X-rays to Confirm the type and extent of the fracture by showing the displacement of the distal radius.

What is Colles Fracture?

A Colles fracture is a type of distal radius fracture characterized by a dorsal displacement of the wrist and hand that causes the broken end to bend backward.

What is the main difference between a Colles fracture and a Smith fracture?

Colles Fracture is a type of fracture involving a dorsal displacement of the wrist and hand, usually resulting from a fall onto an outstretched hand whereas Smith fracture involves a volar displacement of the wrist and hand, commonly caused by a fall onto a flexed wrist or a direct blow to the back of the wrist.

What are the typical causes of these fractures?

Colles Fracture usually caused by a fall onto an outstretched hand (wrist extension). Smith Fracture typically results from a fall onto a flexed wrist or a direct impact to the dorsal side of the wrist.

What treatment options are available for these fractures?

Both fractures may be treated with closed reduction (realigning the bone) and immobilization with a cast or splint and Surgical Interventions like Open reduction and internal fixation (ORIF) with plates and screws are used for displaced, unstable, or intra-articular fractures.