A Smith fracture is a named vertebral fracture occurring most commonly in the lumbar spine. It is similar to that of a Chance fracture and is associated with seat belt injuries. This fracture represents a fracture through the posterior elements including the superior articular processes but not the spinous process, as well as an avulsion fracture of the vertebral body.[1] It is not to be confused with the more commonly referred to Smith's fracture of the wrist.