When a wrist injury is not a Colles' Fracture - abstract

ABSTRACT

Fractures of the lower radius with anterior displacement of the distal fragment are very uncommon injuries. These injuries, designated Smiths' and Barton's Fractures, tend to be readily confused with and misdiagnosed as the commoner Colles' fracture in which the distal fragment is displaced posteriorly, producing the well-known clinical "Dinner Fork Deformity". Between January 1977 and October 1984, 12 fractures of the distal radius with anterior displacement were seen and treated at the Queen Elizabeth Hospital. The case notes and radiographs of these 12 patients were studied, and nine were available for interview and examination. The injuries arose from falls (5), cycle accidents (6), and blows to the back of the hand (1). Two fractures were in children. In ten of the 12 cases the initial diagnosis was incorrect. On average presentation was late, 3 to 4 days, with one patient presenting one month after injury. Most fractures were treated by open reduction and fixation; three, including two children, were treated by manipulation and Plaster-of-Paris (AU)