Most Colles fractures are secondary to a fall on an outstretched hand (FOOSH) with a pronated forearm in dorsiflexion (the position one adopts when trying to break a forward fall). . The proximal row of the carpus (particularly the lunate and scaphoid) transfer energy to the distal radius, both in the dorsal direction and along the long axis of the radius. Most fractures are therefore dorsally angulated and impacted.