Distal radius fractures: nonsurgical treatment options

In conclusion, each of these methods have been proven to be effective in selected patients. None of these methods, however, can be used in all patients. They must be carefully evaluated for use in young patients where anatomic alignment is essential to avoid impairment of function with loss of grip strength and the possibility of developing post-traumatic arthritis. If any of these methods is used, ideal cases would be those with nonarticular fractures, with minimal displacement and minimal bone loss, and some assurance that the fracture will remain stable during treatment. The techniques have been proven to be effective. If, however, fracture reduction is lost with any of these techniques, one must reassess the fracture, especially in the young, and be more aggressive in restoring and maintaining alignment until healing has occurred. Orthopaedic Knowledge Update 3, published in 1990, relates, "Depending on comminution, fixation may be best achieved with plate, screws, Kirschner wires, external fixation or some combination of these." It goes on to state, "In young adults particularly, accurate reduction of the articular surface appears critical to achievement of a good result after a Colles' fracture."