Which fracture is classically seen in postmenopausal women after a fall on an outstretched hand?

• A. Smith fracture
• B. Colles fracture
• C. Torus fracture
• D. Monteggia fracture

Answer: (B)

A fall on an outstretched hand in a person with osteoporosis most commonly causes a Colles fracture. This is a distal radius fracture where the distal fragment shifts upward and tilts dorsally, producing the classic dinner fork deformity. In postmenopausal women, reduced bone density makes the distal radius particularly vulnerable to bending forces from a FOOSH, so the fracture often occurs with dorsal displacement and an extra-articular pattern just above the wrist joint. Clinically you’ll see swelling and a visibly raised, dorsally tilted wrist, and X-rays confirm the distal radius fracture with posterior angulation. This differs from a Smith fracture, which has volar displacement of the distal fragment, from a fracture with the radial head dislocation (Monteggia), or from a buckle/torus fracture more common in children.