The patient was a Pakistani middle-aged guy. About 1 hour before the arrival at our clinic, he fell on the ground somehow. While trying to save himself, he put his left hand first on the ground. His whole body-weight transmitted through his left hand which was put in an outstretched fashion. He felt an excruciating pain in his left wrist. Within half an hour the wrist joint swelled up along with severe pain. He, along with his supervisor, immediately came to our clinic.

From the very first look, it seemed to be a fracture at the left wrist joint or at the lower end of the forearm bones. Fracture at the lower end of forearm bone (radius and ulna are bones of the forearm), especially radius, is quite common in outstretched fall injuries. In the medical field, it is known as Colles' fracture. There is another fracture which is quite opposite of Colles' fracture and its name is Smith's fracture. Smith's fracture takes place if someone falls on the hand when it remains in an inward position.

Our clinic is a polyclinic with two general physicians, one gynaecologist and two dental surgeons. We have a laboratory and an X-ray department with two X-ray technicians. But we don't have any orthopaedic surgeon who can deal with such type of fracture cases, hence we don't put plaster in the fracture cases. If any sprain injury is found, we put crepe bandages and give symptomatic management. In the case of radiological fracture, we refer the patient to the higher centre for putting the plaster and other specialised management.

When any patient arrives with injuries where the chance of fractures are very high, I tell them beforehand that if fractures are found in the X-ray, you have to go such and such place for putting the plaster. Most of the patients agree, with a few exceptions. Today's patient and another patient, a few months before, didn't agree.

In the case of the previous patient, I didn't tell them such thing before doing the X-ray. The X-ray showed a fracture. When I was going to give them the referral letter for the higher centre, they started shouting, "Why didn't you tell before? We would have done everything in the same hospital. You are only doing X-ray but are not putting plaster if needed." Since then I tell every suspected fracture patient the conditions beforehand.

Anyway, my today's patient party also denied doing only X-ray in our clinic. They just wanted something to relieve the pain. I gave the patient a painkiller injection. Later they went to another hospital on their own.

Let us see the differences between Colles' and Smith's fracture in the following image. This image is taken from teachmesurgery

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Last updated: 12.10.2020, 18:55 GMT source

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Height 163 cm		Weight 70 kg		Body Fat %
Waist cm		Thighs cm		Chest cm