Distal radius fractures

Fractures of the distal radius represent the most common fracture in adults. All degrees of severity can occur depending on the fracture morphology, ranging from complete recovery up to extremely severe courses. In addition, the outcome is strongly influenced by possible accompanying carpal injuries. The patient population is divided into young patients under 40 years old with approximately equal proportions of female and male patients presenting with relevant traumatic events and into predominantly female patients over 60 years old with poor bone quality due to osteoporosis and minor traumatic events. Up to approximately 35 years ago treatment was almost exclusively conservative. Surgical procedures, such as Kirschner bore-wire fixation were performed in cases of severe dislocation and external fixation in cases of severe soft tissue problems. The development of modern locking compression plates has led to a paradigm shift in treatment. Conservative treatment is now predominantly limited to stable fractures. The identification of typical errors in the positioning of implants and the development of new X-ray imaging techniques increase the safety of the surgical treatment with volar locking compression plates and establish its position as the standard treatment. At the same time, a more differentiated perception of geriatric trauma patients is evolving, which initiated a change in treatment strategies within this patient population.