Smith Vs. Colles Fracture

Several types of wrist fractures exist. Two of these are Smith and Colles fractures. You need to understand what they are and the treatment options available for both. Here is a review of the Smith and Colles fractures.

What Are Smith and Colles Fractures?

smith vs colles fracture

Image via Flickr by epredator

A Smith fracture occurs on the distal radius. This is the larger radius in the two bones in the arm. A Smith fracture is also associated with palmar angulation of the distal fragment. Smith fractures do not extend to the wrist, hence they are extra-articular. These fractures are usually transverse. Smith fractures are rare and are most often seen in elderly women or young men.

Colles fracture is a broken wrist. It occurs when the radius is broken. When the bone breaks 1 inch from the wrist, it’s called a distal radius break. The broken bone in the fracture usually points upward. It’s the most common fracture, and it generally occurs when you fall over an outstretched arm. The fracture is common among those between the ages of 18 and 25. For older adults, the fracture occurs due to falling when their bones are brittle.

Symptoms of Smith and Colles Fractures

Both fractures have similar symptoms. You will experience immediate pain, bruising, and swelling in the area and tenderness in the surrounding tissue. Depending on the severity of the fracture, the wrist might be in an unnatural position.

Diagnosis of Smith and Colles Fractures

For Smith fractures, the pain is not very severe, and you still have a functioning wrist. You can do first aid and visit the doctor after a while. If you experience some numbness or have pink fingers, or your wrist is at an abnormal angle, you need to rush to the emergency room.

The same applies to Colles fractures. If the pain feels unbearable and you cannot use the hand normally, you need to go to the emergency room. Once you get there, the doctor will do a physical examination and ask how you feel and what you observed. You can have an X-ray done to see the severity of the fracture before you start discussing treatment options. An orthopedist will then treat you.

Treatment of Smith Fracture

Smith fractures are treated by putting the broken bones together in the correct order. There is a need to ensure that the bones remain in place until the injury heals. Treatment varies depending on your age and the extent of the injury. There are surgical and non-surgical treatment options.

For non-surgical treatment, the doctor will perform a closed reduction, which puts the bones back together. After this, the bones will be held in place with a splint or cast. At first, you might use a splint to allow for swelling to go up and down, and then you’ll get a cast.

If the bones are out of place and closed reduction is impossible, an incision will be made to align the bones. The physician can use a few things to hold the bones together, such as a cast, plates, screws, and metal pins.

Treatment of Colles Fracture

Treatment of Coles fractures can be through the use of surgical and non-surgical methods.

For non-surgical treatment, the bones will be aligned and a cast or splint used to keep the bones in place. Splints are used for less active people, while casts are used for those who engage in several activities. The healing process will be monitored over six weeks.

Closed reduction is the option when non-invasive treatment is involved. If the injury is severe, the physician can decide to use open reduction to align the bones. A small incision is made and the bones are aligned and held in place using a cast, plates, metal pins, screws, or external fixators, or a combination.

Can Other Conditions Develop if Treatment is Delayed?

If you delay treatment or do not get proper treatment, your bones will not heal properly. You will not regain the full function of your hand. You can also get complex regional pain syndrome that affects your limbs after injury. It’s believed that the syndrome occurs when the nervous system gets damaged. If you experience pain after an injury, you need to inform your physician so they can check for any additional damage.

Pain Management of Smith and Colles Fractures

The pain you experience when you have a fracture is difficult to determine. If the pain is moderate, you can use ice packs and OTC painkillers and elevate the arm. To get relief from pain and inflammation, you might be given acetaminophen and ibuprofen. Severe pain might have you getting an opioid prescription.

Outlook of Smith and Colles Fractures

When the cast is on, you need to keep it dry. Most people who get Smith or Colles fractures have a full recovery. However, there are some guidelines to promote full recovery.

Getting a fracture doesn’t mean it’s the end of the road. You can still resume your favorite activities once you fully recover from your fracture. Most people get Colles fractures as opposed to Smith fractures. Smith fractures are usually not as severe as Colles fractures but should still be checked out by a specialist. In case you get a wrist injury, you need to understand when to take pain relief medication and when to seek medical attention to prevent any complications from arising.


Dr. John Knight
Dr. John Knight

Dr. Knight is a renowned hand, wrist and upper extremity surgeon with over 25 years of experience. Dr. Knight is a Board Certified Orthopedic Surgeon and Fellowship trained. Dr Knight has appeared on CNN, The Doctors TV, Good Morning America, The Wall Street Journal, The Washington Post, Forbes, The Huffington Post, Entrepreneur, Oxygen network and more.