For years distal radius fractures had been managed by closed reduction and cast application. However, the paradigm has changed with better understanding of distal radius anatomy and better gadgets.

Now the treatment with closed reduction and cast immobilization is indicated in
1. Stable fractures in which the the goals of treatment can be expected to be achieved.

2. Patients with low functional demands.

Stable Fractures

Stable fractures can be considered for non operative treatment depending on fracture type and and patient.

There is no particular criteria as to  which fracture is to be considered stable and which not but following things needs to be considered. These factors have been associated with redisplacement after cast immobilization

• A fracture combined with ligamentous injury is an unstable fracture
• Greater initial displacement of the fracture
• Elderly age
• Metaphyseal comminution
• Displacement after closed treatment

Patient Demands

If the patient has a low functional demand he or she may not choose to undergo surgery though recent studies have suggested better outcomes of surgery in active elderly patients.

The decision therefore must also consider  physical demands, health status, independent lifestyle, vocation, , and other comorbid conditions.

Technique of Closed Reduction of Distal Radius Fracture