Smith Fracture Review.

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Abstract

Conflict of interest statement: Disclosure: Jeremy Schroeder declares no relevant financial relationships with ineligible companies. Disclosure: Matthew Varacallo declares no relevant financial relationships with ineligible companies. 5. J Emerg Med. 1998 May-Jun;16(3):445-52. doi: 10.1016/s0736-4679(98)00016-x. Pisiform and hamulus fractures: easily missed wrist fractures diagnosed on a reverse oblique radiograph. Lacey JD(1), Hodge JC. Author information: (1)Department of Plastic Surgery, McGill University, Quebec, Canada. We present a review of the current literature involving fractures of the pisiform and hook of the hamate. This is highlighted by two cases in which the fracture lines are seen only on the reverse oblique wrist radiograph, a view obtained with the wrist in a supinated rather than a pronated position. These fractures are not seen on standard two or three view wrist examination. Both of these fractures were initially missed in the emergency department. Serious sequelae can result from both of these injuries and can be avoided if diagnosed acutely. The reverse oblique radiograph can be quick, cost-effective, and diagnostic in this setting. If properly treated by immobilization or excision, the results can be excellent. DOI: 10.1016/s0736-4679(98)00016-x