Smith fracture

Smith fracture: Extra-articular fracture of the distal radius with associated palmar (volar) angulation of the distal fracture fragment. Also called Goyrand fracture or reverse Colles fracture.

Smith fracture Goyrand fracture LITFL distal radius
Smith fracture

History

1832Jean-Gaspar-Blaise Goyrand, who noted that a fracture of the distal end of the forearm could be displaced palmarly as well as dorsally

1847Robert William Smith describe the characteristics of Colles’ fracture in his book – A Treatize on Fractures in the Vicinity of Joints and on Certain Forms of Accidents and Congenital Dislocations. In this tome Smith also described the variation of wrist fracture whereby the distal fragment is displaced in a volarwards (as previously noted by Goyrand).

Smith Original description and Drawing

This is an injury of exceedingly rare occurrence, and one which presents characters closely resembling those of dislocation of the carpus forwards. It generally occurs in consequence of a fall upon the back of the hand, and the situation of the fracture is from half an inch to an inch above the articulation; it is accompanied by great deformity, the principal features of which are a dorsal and a palmar tumour, and a striking projection of the head of the ulna at the posterior and inner part of the forearm; the dorsal tumour occupies the entire breadth of the forearm, but is most conspicuous internally, where it is constituted by the lower extremity of the ulna displaced backwards; from this point, the inferior outline of the tumour passes obliquely upwards and outwards, corresponding in the latter direction of the lower end of the superior fragment of the radius. Immediately below the dorsal swelling there is a well marked sulcus, deepest internally below the head of the ulna, directed nearly transversely, but ascending a little as it approaches the radial border of the forearm.

Smith, 1847
1847 Smith fracture original drawing
1847 Smith fracture. Original drawing from a man who “in endeavouring to save himself from being run over by a car, fell with great violence upon the back of the hand.”

Associated Persons


Alternative names

  • Goyrand fracture
  • Smith–Goyrand fracture
  • Reverse Colles fracture

References


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the names behind the name

Emergency physician MA (Oxon) MBChB (Edin) FACEM FFSEM with a passion for rugby; medical history; medical education; and informatics. Asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | vocortex |

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