[Current status of the treatment of distal radius fracture]

The problems encountered in the treatment of fractures of the distal radius lie in the frequent redislocation even after correct reduction. The ASIF classification should be used for a fracture-oriented therapeutic approach. Therefore, only fractures that are not dislocated should be treated conservatively. The majority of fractures require closed or open reduction followed by internal fixation. Articular fractures, in particular, require precise reduction of the articular surface. Following the reduction the fractures should be stabilized, usually with Kirschner wires. The more severe fractures--especially those falling in C1-C3 according to the ASIF classification--can be adequately treated by open reduction with a dorsal or volar approach and subsequent stabilization with the T plate, most often combined with other methods of internal fixation. Open fractures and complex traumas of the upper extremity should be treated by means of a fixateur externe for 2-4 weeks, followed by a change of treatment; the basic decision is usually between internal fixation with plates and further conservative treatment alone. The relatively poor long-term results obtained with treatment of distal radial fractures require that therapeutic guidelines be elaborated for the treatment of these fractures.