Smith’s Fractures is also known as a Goyrand Fracture in French literature.
Smith’s fracture is palmarly displaced distal radius fracture. It is referred
to as “GARDEN SPADE” deformity. Smith’s fracture is a reversed Colles fracture.
Smith’s fracture account for less than 3% of all fractures of the radius and
ulna and have a bimodal distribution: young males (most common) and elderly
Smith’s fractures usually occur in one of the 2ways:
onto a flexed wrist
blow to the back of the wrist
SIGNS AND SYMPTOMS
acute pain in the wrist from an impact or a fall.
in the affected area.
felt while moving the wrist.
of hand being downwards.
may develop a cracking noise.
of fever few hours after injury.
SMITH’S FRACTURE can be broadly be classified into two types.
This is frequently called as mild fracture. The treatment for this condition
is casting. Once the problem is diagnosed immediate attention must be given.
The area of the fracture gets healed in few weeks.
This type of fracture is very severe in nature. Displaced generally leads to
very serious and dangerous damage to the bone. In this condition the joint of
the wrist is often displaced forward creating discomfort over the wrist while
moving in some angles.
Types of SMITH’S FRACTURE classified
based on the type of injury.
Smith’s Fractures can be treated with manipulation and reduction.
Conservatives measures involve closed reduction with use of local anesthesia
and then casting of hand to thumb. It takes about 10 weeks for complete
recovery, which involves period of immobilization for about a month and then
splinting for 6 weeks.
Surgery is needed in majority of cases with Smiths Fracture as the deformity
cannot be treated with nonsurgical means. This method is termed as OPEN
This is done by creating an incision for interpretation of fracture and to get
it back to its normal place. This at times requires pins, screws, etc for
This is essential for everyone for appropriate healing and normalizes
function of wrist and hand can include:
Scoliosis is a lateral (toward the side) curvature
in the normally straight vertical line of the spine. When viewed from the side,
the spine should show a mild roundness in the upper back and shows a degree of
swayback (inward curvature) in the lower back. When a person with a
normal spine is viewed from the front or back, the spine appears to be straight.
When a person with scoliosis is viewed from the front or back, the spine
appears to be curved.
What Causes Scoliosis?
There are many types and causes of scoliosis,
Congenital Scoliosis. Caused by a bone abnormality present at
Neuromuscular Scoliosis. A result of abnormal muscles or
nerves. Frequently seen in people with spina bifida or cerebral palsy or
in those with various conditions that are accompanied by, or result in,
Degenerative Scoliosis. This may result from traumatic (from an
injury or illness) bone collapse, previous major back surgery,
osteoporosis (thinning of the bones).
Idiopathic Scoliosis. The most common type of scoliosis,
idiopathic scoliosis, has no specific identifiable cause. There are many
theories, but none have been found to be conclusive. There is, however,
strong evidence that idiopathic scoliosis is inherited.
Who Gets Scoliosis?
Approximately 2% to 3% of Americans at age 16 have
scoliosis. Less than 0.1% have spinal curves measuring greater than 40 degrees,
which is the point at which surgery becomes a consideration. Overall, girls are
more likely to be affected than boys. Idiopathic scoliosis is most commonly a
condition of adolescence affecting those ages 10 through 16. Idiopathic
scoliosis may progress during the “growth spurt” years, but usually will not
progress during adulthood.
How is Scoliosis Diagnosed?
Most scoliosis curves are initially detected on
school screening exams, by a child’s pediatrician or family doctor, or by a
parent. Some clues that a child may have scoliosis include uneven shoulders, a
prominent shoulder blade, uneven waist, or leaning to one side. The diagnosis
of scoliosis and the determination of the type of scoliosis are then made by a
careful bone exam and an X-ray to evaluate the magnitude of the curve.
What is the treatment for Scoliosis?
The majority of adolescents with significant
scoliosis with no known cause are observed at regular intervals (usually every
four months to six months), including a physical exam and a low-radiation
Treatments for Scoliosis Include:
Bracing is the usual treatment choice for
adolescents who have a spinal curve between 25 degrees to 40 degrees —
particularly if their bones are still maturing and if they have at least 2 years
of growth remaining.
The purpose of bracing is to halt progression of the curve. It may provide a
temporary correction, but usually the curve will assume its original magnitude
when bracing is eliminated.
Those who have curves beyond 40 degrees
to 50 degrees are often considered for scoliosis surgery. The goal is to make
sure the curve does not get worse, but surgery does not perfectly straighten
the spine. During the procedure, metallic implants are utilized to correct some
of the curvature and hold it in the correct position until a bone graft, placed
at the time of surgery, consolidates and creates a rigid fusion in the area of
the curve. Scoliosis surgery usually involves joining the vertebrae together
permanently– called spinal fusion.