[4] Distal radius fractures represent between 25% and 50% of all broken bones and occur most commonly in young males and older females.

[5] Swelling, deformity, tenderness, and loss of wrist motion are normal features on examination of a person with a distal radius fracture.

"Dinner fork" deformity of the wrist is caused by dorsal displacement of the carpal bones (Colle's fracture).

Swelling and displacement can cause compression on the median nerve which results in acute carpal tunnel syndrome and requires prompt treatment.

Malunion, however, is not uncommon, and can lead to residual pain, grip weakness, reduced range of motion (especially rotation), and persistent deformity.

Half of nonosteoporotic patients will develop post-traumatic arthritis, specifically limited radial deviation and wrist flexion.

People who fall on the outstretched hand are usually fitter and have better reflexes when compared to those with elbow or humerus fractures.

However, it is unclear whether intercarpal ligaments and triangular fibrocartilage injuries are associated with long term pain and disability for those who are affected.

[4][9] Indications for each depend on a variety of factors such as the patient's age, initial fracture displacement, and metaphyseal and articular alignment, with the ultimate goal to maximize strength and function in the affected upper extremity.

[5] Surgeons use these factors combined with radiologic imaging to predict fracture instability, and functional outcome to help decide which approach would be most appropriate.

Treatment is often directed to restore normal anatomy to avoid the possibility of malunion, which may cause decreased strength in the hand and wrist.

[4] The majority of distal radius fractures are treated with conservative nonoperative management, which involves immobilization through application of plaster or splint with or without closed reduction.

[5] In displaced distal radius fracture, in those with low demands, the hand can be cast until the person feels comfortable.

If the post reduction radiology of the wrist is acceptable, then the person can come for follow up at one, two, or three weeks to look for any displacement of fractures during this period.

[5] Failure of nonoperative treatment leading to functional impairment and anatomic deformity is the largest risk associated with conservative management.

[5] Despite these risks with nonoperative treatment, more recent systematic reviews suggest that when indicated, nonsurgical management in the elderly population may lead to similar functional outcomes as surgical approaches.

In these studies, no significant differences in pain scores, grip strength, and range of motion in patients' wrists occurred when comparing conservative nonsurgical approaches with surgical management.

Although the nonsurgical group exhibited greater anatomic misalignment such as radial deviation, and ulnar variance, these changes did not seem to have significant impact on overall pain and quality of life.

However, several studies suggest this approach is largely ineffective in patients with high functional demand, and in this case, more stable fixation techniques should be used.

[20][21][22] Surgical options have been shown to be successful in patients with unstable extra-articular or minimal articular distal radius fractures.

[5] The most common complication associated with nonbridging external fixation is pin tract infection, which can be managed with antibiotics and frequent dressing changes, and rarely results in reoperation.

[5] Although major complications (i.e. tendon injury, fracture collapse, or malunion) result in higher reoperation rates (36.5%) compared to external fixation (6%), ORIF is preferred, as this provides better stability and restoration of the volar tilt.

These scores includes assessment of range of motion, grip strength, ability to perform activities of daily living, and radiological picture.

[5] In children, the outcome of distal radius fracture is usually very good with healing and return to normal function expected.

[citation needed] In young patients, the injury requires greater force and results in more displacement, particularly to the articular surface.

[citation needed] In the elderly, distal radius fractures heal and may result in adequate function following nonoperative treatment.

After that, Robert William Smith, professor of surgery in Dublin, Ireland, first described the characteristics of volar displacement of distal radius fractures.

Ombredanne, a Parisian surgeon in 1929, first reported the use of nonbridging external fixation in the management of distal radius fractures.

Bridging external fixation was introduced by Roger Anderson and Gordon O’Neill from Seattle in 1944 due to poor results in conservative management (using orthopaedic cast) of distal end radius fractures.

Raoul Hoffman of Geneva designed orthopaedic clamps, which allow adjustments of the external fixator to reduce the fractures by closed reduction.