A 51-Year-Old Woman with Wrist Pain After a Fall

Differential Diagnosis

• Barton’s fracture
• Distal radial metaphysis fracture
• Distal styloid fracture
• Radial styloid fracture

Diagnosis
The patient has an acute fracture of the distal radial metaphysis.

Learnings

• Often, as in this case, the fracture can be very subtle if nondisplaced. In elderly patients with osteopenia, the diagnosis can be very difficult. Subtle linear lucency or cortical disruption should be viewed with suspicion
• The eponyms Colles and Smith are used for fractures which are angulated dorsally and volarly, respectively
• It is very important to look for complicating factors such as intra-articular extension, involvement of distal ulnar joint, or radial shortening