In non-geriatric adults (aged 18 to under 65), a distal radius fracture that fails to hold adequate alignment after closed reduction meets criteria for operative intervention. Moderate evidence supports that surgical fixation in this population leads to improved radiographic and patient-reported outcomes.
This protocol applies to adults aged 18 to under 65 years who, after fracture reduction, demonstrate one or more of the following radiographic findings:
The management centres on operative fixation of the distal radius. Multiple surgical fixation techniques are addressed in the full protocol, with evidence comparing their outcomes in this age group.
Moderate evidence supports that for non-geriatric patients (most commonly defined in studies as under 65 years of age), operative treatment for fractures with post reduction radial shortening >3mm, dorsal tilt >10 degrees, or intraarticular displacement or step off >2 mm leads to improved radiographic and patient reported outcomes.
Strong evidence suggests no significant difference in radiographic or patient reported outcomes between fixation techniques for complete articular or unstable distal radius fractures, although volar locking plates lead to earlier recovery of function in the short term (3 months).