A Smith fracture is a specific kind of broken wrist. If you have a Smith fracture, you might need surgery and will probably need to wear a cast for several weeks. It may take about a year to fully recover from a Smith fracture.
A Smith fracture is a specific type of broken wrist. It’s caused by falling or experiencing another trauma while your wrist is bent or flexed.
There are lots of different bone fractures, and it’s easy for the different names to sound confusing. For example, you may see Smith fractures referred to as a type of distal radius fracture. The radius is one of the bones in your forearm, and its distal end is toward your wrist.
Each of the specific details you might read or hear about tells your healthcare provider which bones are broken, where they’re broken, how they broke and what they look like inside of your wrist right now. Think about all these names for fractures like the magnification settings on a microscope that helps your healthcare provider zoom in on your specific injury. No matter which names and terms are applied to your injury, the most important first step is getting your wrist examined by your healthcare provider as soon as possible.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
The type of wrist fracture you have depends on how your bones broke and what the break itself looks like. Smith fractures usually come from falling with your wrist closed or flexed inward, or from a direct blow to the back of your hand.
If you’re diagnosed with a Colles fracture, the broken piece of your wrist bone (radius) points backward. Smith fractures are the opposite: The broken end of your bone points forward.
Barton fractures are similar to Smith fractures — they both usually come from falling on your wrist when it’s closed or flexed in. But with Barton fractures, your broken bones angle up or away from your palm.
Smith fractures can happen to anyone because they’re usually caused by an accident or trauma.
One important risk factor is osteoporosis. If you have osteoporosis, your bones are more susceptible to fractures. Anyone can develop it, but women are four times more likely than men. People older than 50 are also at an increased risk of osteoporosis.
Wrist fractures, in general, are 20% of all broken bones treated in emergency rooms, and the second most common broken bone in adults older than 50.
Compared to other types of wrist breaks, Smith fractures are rare. They’re only around 5% of all broken wrists.
Symptoms of Smith fracture include:
Falls are by far the most common cause. Most people diagnosed with a Smith fracture landed on the back of their wrist with their hand flexed or bent in toward their body.
Car accidents, sports injuries and other significant traumas also cause Smith fractures.
You might see the cause of your broken wrist referred to as the “mechanism for injury.” This is just the medical term for “cause” and helps your healthcare provider know how you were hurt.
A Smith fracture is diagnosed with an X-ray. This tells your healthcare provider which of your bones are broken and which type of fracture you have. All broken wrists require an X-ray.
In addition to confirming your broken wrist, the X-ray will give your healthcare provider important information such as how clean the break is or how many pieces there are, how much space there is between your bones and whether other bones are damaged, too.
Which tests you’ll need will depend on the cause and severity of your injury. You’re more likely to need extra imaging if your wrist was fractured in a more dangerous trauma like a car accident or falling off a ladder.
How your Smith fracture is treated depends on the severity of the original break. Your broken bones need to heal back together, and there are several ways to make sure they’re repaired correctly.
If your break is mild and your bones didn’t move far out of place, you might only need a splint or cast. Splinting usually lasts for three to five weeks. If you need a cast, it’ll likely be longer, typically six to eight weeks. You’ll also likely need follow-up X-rays to make sure your bones are healing correctly.
More severe breaks require a closed reduction to set (realign) your bones. During this nonsurgical procedure, your healthcare provider will physically push and pull your arm and wrist to line up your broken bones. To prevent you from feeling pain during the procedure, you’ll receive one of the following:
After the closed reduction, your healthcare provider will put your wrist in a cast or splint, and you’ll need a follow-up appointment with a specialist to discuss your treatment options.
The most intense fractures require surgery. Your surgeon will repair your broken bones and insert a metal plate and screws into your wrist to hold it together.
Recovery time for surgery is longer than other methods. You’ll need a splint following surgery to help protect your bones and help them heal. You’ll also require physical therapy to help you regain your strength and mobility.
Talk to your healthcare provider before taking any medications to reduce pain after any treatment. Over-the-counter pain relievers (such as ibuprofen or acetaminophen) may reduce pain and swelling.
Breaking your wrist almost always happens accidentally. Because falls are by far the most common cause of wrist fractures, make sure your home and workspace are free from clutter that could trip you or others. Make sure the adults older than 50 in your life practice good fall prevention, too.
Talk to your healthcare provider about osteoporosis and how you can prevent bone loss with the right diet, exercise routine and regular bone density screening, as well.
Healing time depends on the severity of your fracture and which treatments you needed. It can take anywhere from a few months to more than a year to recover.
Many people will experience stiffness and pain in their wrist that can last for months or even years after their fracture heals.
Regardless of which kind of treatment you need, a Smith fracture will impact your life while you heal:
Your healthcare provider will also help you understand how long you’ll need to miss work, school or other activities while you heal.
Most people can return to light exercise (walking, jogging, lower body workouts) a month or two after having their cast removed or after surgery. It can take as long as six months before you’re able to resume intense activity like heavy workouts or contact sports, though.
Smith fracture complications can include:
If you think you have a wrist fracture, get help right away. Go to the emergency room if you’ve experienced a trauma and have any of the following symptoms:
Make sure you tell your healthcare provider or the emergency responders everything that happened.
A note from Cleveland Clinic
Breaking a bone is always scary, especially if it happens during a traumatic event. Fortunately, wrist fractures are treatable, and most people are able to resume all the activities they enjoyed before their injury. If you think you have a Smith fracture, or any other kind of broken wrist, get it examined as soon as possible. If you have specific risk factors like osteoporosis, make sure you talk to your healthcare provider about how you can keep your bones strong to prevent fractures.
Last reviewed by a Cleveland Clinic medical professional on 02/26/2022.
Learn more about our editorial process.