![]() ![]() 3, 4 “Colles’ fracture,” which is a distal radius fracture with dorsal displacement of the lower fragment was first described in 1814 by Abraham Colles in his publication on “fractures of the carpal extremity of the radius.” 5 In 1847, Robert William Smith first reported a “Smith's fracture,” which is a volar displacement of the distal radius fracture fragment, and stated that it generally resulted from a fall on the back of the hand. 2 Low-energy injury is the main cause of distal radius fractures, with 66–77% of fractures occurring after a fall from standing height. 1 They account for 17.5% of all adult fractures. J Orthop Res 35:2435–2441, 2017.ĭistal radius fractures are the most common type of fractures, with 607,000 cases annually occurring in the United States. This study demonstrated that Smith's fracture results from falling on the palm of the hand. Smith's fractures occurred in 7 of 10 wrists in the experimental study, whereas no Colles’ fractures were observed. FEM analysis showed that Smith's fractures occurred when the angle between the long axis of the forearm and the ground was 30°–45° in the sagittal plane and 75°–90° in the coronal plane. Six patients were uncertain of their arm position at the time of injury. Injury resulting from a fall on the palm of the hand, the dorsum, or ulno-dorsum of the hand, and fisting handle was observed in 16 cases (61%), 3 cases (12%), and 1 case (4%), respectively. Twenty-six patients (5 males and 21 females) with Smith's fractures were enrolled in this study. These predictions were then used in ten freshly frozen cadavers to provide experimental proof of Smith's fractures resulting from the impact on the palmar side. Second, we created three-dimensional finite element models (FEMs) to predict the influence of arm position on the type of injury resulting from a fall. First, a survey was conducted for investigating the mechanism of injury and arm position at the time of injury among patients with Smith's fractures who consulted at our outpatient clinic. The aim of this study was to clarify the pathogenesis of Smith's fracture in basic clinical aspects. Orthopedic trauma surgeons often encounter Smith's fracture in patients who report that they have fallen on the palms of their hands. ![]()
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