Management of distal radial fractures

The older population continues to grow and, at the same time, live more active lives; as a consequence, the incidence of distal radial fractures can be expected to increase. There is no Level-I clinical evidence suggesting a superior modality for treatment of distal radial fractures. The lunate facet has a considerable volar extension at the distal extent of the pronator quadratus and subsequently has an important role in fracture pathomechanics and stability. Application of a volar plate with angular stable fixation has been used successfully in a number of cohort studies but needs to be examined in stringent trials to determine if there is any benefit when compared with other treatment modalities. Irritation of the flexor pollicis longus and irritation of extensor tendons are possible complications of fixation with a locked volar plate.