Types of fracture

There are lots of fractures. We have tried to narrow it down a wee bit.

A dorsal displacement in a Colles fracture.

Arm and wrist

Top of humerus

Often breaks in the elderly after a fall. Also seen in RTAs. Can be treated conservatively with a collar-and-cuff. If it is comminuted (multiple pieces), may need open reduction and internal fixation.

Colles' fracture

Very common, especially in old osteoporotic ladies who fall forwards on an outstretched hand. You get a dorsal displacement. This means that the back of the hand (the bit with the nails on) goes a bit more backwards. Use some anaesthesia, then reduce it and put it in a backslab.

Smiths' fracture

This is known as a reverse Colles, as its exactly the same, except there is ventral displacement (the hand displaces forwards). It happens when you fall forwards on a flexed hand, or backwards on an outstretched one. Managed the same way.

Scaphoid fracture

Happens from falling on the hand. Get a pain in the anatomical snuff box. Important because there is only a distal blood supply, and a fracture down the middle can mean the proximal end doesn't get blood. Then is dies. That's bad. If it's broken, can usually be supported with a thumb and wrist cast, otherwise, might need surgery.