Which fracture is a distal radius fracture with volar displacement, due to a fall on the back of the hand?

• A. Boxer’s fracture
• B. Hangman’s fracture
• C. Smith fracture
• D. Colles fracture

Answer: (C)

Displacement direction of the distal fragment in a distal radius fracture defines the specific pattern. If the distal fragment moves toward the palm (volar displacement), it’s a Smith fracture—the reverse of the more common Colles fracture, which shows dorsal displacement. The scenario describes a fall on the back of the hand that produces wrist flexion and drives the distal radius fragment toward the palmar side, producing a Smith fracture.

Boxer’s fracture refers to a fracture of the neck of the fifth metacarpal from punching. Hangman’s fracture is a cervical spine injury (pars interarticularis of C2) from hyperextension. Colles fracture involves dorsal (posterior) displacement of the distal radius from a fall on an outstretched hand with the wrist extended.