This 2010 AAOS clinical practice guideline synthesizes a systematic review of the literature on distal radius fracture treatment in adults, producing 29 graded recommendations to guide clinical decision-making. It asks: what does the best available evidence say about operative vs. nonoperative management, immobilization strategy, adjuvant treatments, and postoperative rehabilitation?
When evaluating a distal radius fracture post-reduction, use the thresholds of >3 mm shortening, >10° dorsal tilt, or >2 mm articular step-off to guide the surgical conversation — and always get a true lateral to rule out DRUJ dislocation.
The paucity of strong recommendations across all 29 questions is itself a teaching point: most distal radius fracture management decisions still rest heavily on clinical judgment, not level I evidence.
This 2010 AAOS clinical practice guideline synthesizes a systematic review of the literature on distal radius fracture treatment in adults, producing 29 graded recommendations to guide clinical decision-making. It asks: what does the best available evidence say about operative vs. nonoperative management, immobilization strategy, adjuvant treatments, and postoperative rehabilitation?
When evaluating a distal radius fracture post-reduction, use the thresholds of >3 mm shortening, >10° dorsal tilt, or >2 mm articular step-off to guide the surgical conversation — and always get a true lateral to rule out DRUJ dislocation.
The paucity of strong recommendations across all 29 questions is itself a teaching point: most distal radius fracture management decisions still rest heavily on clinical judgment, not level I evidence.