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.

History of the Smith fracture

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

1847 – Robert William Smith described 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: 162

Associated Persons

• Robert William Smith (1807-1873) [Smith fracture]
• Jean-Gaspard Blaise Goyrand (1803-1866) [Goyrand fracture]
• Abraham Colles (1773 – 1843) [Colles fracture]

Alternative names

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

References

Historical references

• Goyrand G. Memoirs sur les fractures de l’extrémité inferieure de radius, qui simulent les luxations di poignet. Gazette médicale de Paris. 1832; 3: 664-667
• Smith RW. On Fractures of the Bones of the Fore-arm in the Vicinity of the Wrist Joint. In: A Treatise on Fractures in the Vicinity of Joint and on Certain Forms of Accidental and Congenital Dislocations. Dublin. 1847: 129-175.

Review references

• Fernandez DL, Jupiter JB. Fracture of the Distal End of the Radius: Historical Perspective. In: Fractures of the Distal Radius. 2002: 1-21
• Thurston AJ. ‘Ao’ or eponyms: the classification of wrist fractures. ANZ J Surg. 2005 May;75(5):347-55.
• Cooney WP. Clinical Epidemiology of Orthopedic Trauma. LWW. 2010
• Zhang Y. Clinical Epidemiology of Orthopedic Trauma. Thieme. 2012