Tag Archive for: AO Classification

Comprehensive Management of Distal End Radius Fractures in Adults: A Clinical Review and Decision-Making Approach

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Review Article | Vol 12 | Issue 1 | January-June 2026 | page: 25-30 | Sachin Kale, Altaf Warid, Gaurav Sharma, Ashok Shyam, Ashok Ghodke, Nikhil Makhija

DOI: https://doi.org/10.13107/ti.2026.v12.i01.82 Submitted: 07/01/2026; Reviewed: 02/02/2026; Accepted: 06/03/2026; Published: 10/04/2026

Authors: Sachin Kale [1], Altaf Warid [1], Gaurav Sharma [1], Ashok Shyam [1], Ashok Ghodke [1], Nikhil Makhija [1]

[1] Department of Orthopaedics, Dr. D.Y. Patil Medical College, Navi Mumbai, Maharashtra, India. Address of Correspondence Dr. Sachin Kale Department of Orthopaedics, Dr. D.Y. Patil Medical College, Navi Mumbai, Maharashtra, India. E-mail: sachinkale@gmail.com

Abstract

Background: Distal radius fractures represent one of the most frequently encountered injuries in orthopaedic practice worldwide, accounting for a significant proportion of upper limb fractures across all age groups. These fractures demonstrate a bimodal distribution, occurring commonly in young individuals following high-energy trauma and in elderly osteoporotic patients after low-energy falls. Over the past few decades, the management of distal radius fractures has undergone substantial evolution, driven by advancements in imaging modalities such as computed tomography, a deeper understanding of wrist biomechanics, and the development of improved fixation techniques. These advances have enabled more precise fracture characterization and have contributed to better functional restoration. Objectives: This review aims to provide a comprehensive yet practical overview of distal radius fractures, with particular emphasis on systematic clinical evaluation, commonly used classification systems, and contemporary evidence-based management strategies. The goal is to aid clinicians in making informed decisions tailored to individual patient and fracture characteristics. Methods: A narrative review was conducted using standard orthopaedic textbooks, peer-reviewed journal articles, and widely accepted clinical guidelines. Relevant literature focusing on epidemiology, fracture classification (including commonly used systems such as Frykman, Fernandez, and AO/OTA), imaging modalities, and both conservative and surgical management approaches was analyzed to synthesize current best practices. Results: The management approach to distal radius fractures largely depends on fracture stability, displacement, intra-articular involvement, and patient-related factors such as age, bone quality, functional demands, and comorbidities. Stable, extra-articular fractures with acceptable alignment generally respond well to conservative treatment, including immobilization with casting. However, unstable fractures—characterized by dorsal comminution, significant displacement, loss of radial height or inclination, and intra-articular extension—are associated with a higher risk of malunion and functional impairment when treated non-operatively. Surgical intervention in such cases has been shown to provide superior anatomical reduction and improved functional outcomes. Among surgical options, volar locking plate fixation has gained widespread acceptance due to its biomechanical stability, ability to maintain reduction in osteoporotic bone, and facilitation of early mobilization. Other modalities, including external fixation, percutaneous pinning, and dorsal plating, remain relevant in selected scenarios. Conclusion: The management of distal radius fractures should be individualized, considering both fracture-specific characteristics and patient-related factors. A thorough clinical and radiological assessment is essential for optimal decision-making. Modern fixation techniques, particularly volar locking plates, have significantly enhanced the ability to achieve stable fixation and early functional recovery. Nevertheless, careful patient selection and adherence to sound surgical principles remain critical to achieving favorable outcomes. Keywords: AO Classification, Distal End Radius Fractures, Volar Plating, Decision Making

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How to Cite this article: Kale S, Warid A, Sharma G, Shyam A, Ghodke A, Makhija N | Comprehensive Management of Distal End Radius Fractures in Adults: A Clinical Review and Decision-Making Approach | January-June 2026; 12(1): 25-30 | https://doi.org/10.13107/ti.2026.v12.i01.82

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