Smith's Fracture

Your caregiver has diagnosed you as having a fracture of the main bone in your forearm, the radius. This fracture (break in bone) is a break in the radius near the wrist. The radius is the long bone of the forearm located on the same side as your thumb. There may also be a fracture of the ulna near the wrist. This is the long bone on the same side of the wrist as the little finger. A Smith's fracture refers to a break in which the end of the radius or radius and ulna has been knocked out of place in a direction towards the palm of your hand. Sometimes this usually must be put back into position (set) before casting or splinting. A cast or splint is used to protect and keep your injured bones in good position to heal. Sometimes a splint with an ace wrap is used first if there is too much swelling or it is thought that more swelling will occur. After a few days a cast may be applied if the splint will not hold the position well enough. The cast or splint may be on for 5 to 6 weeks, with individual variations. X-rays may be taken while the cast is on to make sure the bones stay in good position. Commonly this fracture requires an operation to put the fracture into ideal position. This most often requires the use of metal plates and screws.

HOME CARE INSTRUCTIONS

  • To lessen the swelling, keep the injured part raised while sitting or lying down. Keeping the injury above the level of your heart (the center of the chest) will decrease swelling and pain.

  • Apply ice to the injury for 15 to 20 minutes, 3 to 4 times per day, while awake for 2 days. Put the ice in a plastic bag. Place a thin towel between the bag of ice and your cast.

  • If you have a plaster or fiberglass cast:

  • Do not try to scratch the skin under the cast using sharp or pointed objects.

  • Check the skin around the cast every day. You may put lotion on any red or sore areas.

  • Keep your cast dry and clean.

  • If you have a plaster splint:

  • Wear the splint as directed.

  • You should loosen the elastic around the splint if your fingers become numb, tingle, or turn cold or blue.

  • If you have been put in a removable splint, wear and use as directed.

  • Do not put pressure on any part of your cast or splint. It may break. Rest your cast or splint only on a pillow for the first 24 hours until it is fully hardened.

  • Your cast or splint can be protected during bathing with a plastic bag. Do not lower the cast or splint into water.

  • See your caregiver as directed. It is very important to keep all follow-up referrals and appointments in order to avoid any long-term problems with your wrist including chronic pain or inability to move the wrist normally.

  • Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver.

SEEK IMMEDIATE MEDICAL CARE IF:

  • Your cast gets damaged or breaks.

  • You have continued severe pain or more swelling than you did before the cast was put on, and the pain is not controlled with medications.

  • Your skin or nails below the injury turn blue or grey or feel cold or numb.

  • Tingling of the fingers or severe pain with motion of the fingers

  • There is a bad smell or new stains and/or purulent (pus like) drainage coming from under the cast.