Colles and Smith Fractures

In a Colles fracture, the distal fragment is displaced in which direction relative to the proximal fragment?

Which of the following is the most common associated injury in a Colles fracture?

A 65-year-old woman presents to the emergency department with severe pain and swelling over the dorsal aspect of her right wrist following a fall on an outstretched hand (FOOSH). On clinical examination, there is a 'dinner fork' deformity. Which investigation is most appropriate to confirm the diagnosis and assess for associated injuries?

A 62-year-old woman with osteoporosis presents to the emergency department 2 hours after a fall on an outstretched hand. Clinical examination reveals a 'dinner fork' deformity of the right wrist with dorsal angulation. X-rays confirm a Colles fracture with dorsal displacement and angulation. The hand is warm, well-perfused, and sensations are intact. What is the most appropriate immediate next step in management?

A 35-year-old man presents 4 hours after a fall onto a flexed wrist. Examination reveals a 'garden spade' deformity with volar angulation and displacement of the distal radius. Neurovascular examination is normal. X-rays confirm a Smith fracture (volar Barton type) with intra-articular extension and 4 mm step-off at the radiocarpal joint. After initial analgesia, what is the most appropriate next step in management?