Smith’s Fracture

This patient had a displaced looking wrist. However the POCUS didn’t look particularly displaced at all. I was wondering about the discrepancy but not enough to get the old brain in gear (do U/S waves cause dementia in the operator?). I should have learned from my last POCUS on a Smith’s that they look very benign unless you look from the volar side, which makes sense. Sure enough when I moved the probe around to the volar side (after the X-ray), the displacement was obvious. After that I proceeded as for a Colles but in reverse. I dorsally displaced it a bit as I was expecting slippage and I hoped that it would end up in neutral.
[Editor’s note: The 1st image shows the initial POCUS scan. The 2nd image shows the view after the 1st reduction attempt. The 3rd image shows good reduction after the 2nd attempt]