Despite the frequency of distal radius fractures, studies in the existing literature have not been able to determine the optimal surgical strategies for various fracture patterns. Numerous clinical articles have been written, but most are level IV case series or expert opinion reviews. Good biomechanics studies have been published that suggest advantages of certain fixation methods over others. Transference of these expectations to clinical reality, however, requires well-controlled patient trials. In large part, this has not happened. This article reviews the theoretical pros and cons of different surgical strategies used for adult distal radius fractures, and then looks at randomized controlled trials that have been published in the last 5 years.
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