“The wrist is the key joint of the hand” (Bunnell) [1] and represents together with the forearm an inseparable anatomical and biomechanical unit. The wrist as an executive part of the body, enables optimal positioning of “the hand” to allow the grasping function. Consequently, the distal radius and ulna form the distal radioulnar as well as the radiocarpal joint and both are important to carry out daily activities. Injuries to the distal radius are one of the most common in the upper extremities and forecasts predict a significant increase in the future. This perhaps accounts for the many new publications emerging to improve treatment and outcome. Although, every orthopedic or hand surgeon is faced with this very commonly occurring type of injury, still no unanimous consensus in the literature has been found about the best form of treatment. Even basic questions for example, which fracture has to be treated operatively or conservatively and which operative fixation technique offers the best solution for the patient in respect of functional outcome and lowest complication rates are not clarified. This is particularly true in elderly patients. None of the routine treatments we use are evidence based. This subject is so controversial that even Cochrane data base reviews are unable to give definitive recommendations for optimal treatment. Furthermore, today’s available classifications are more suitable for research purposes than supporting the treating surgeons in their decision-making process.
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