Does a distal radial fracture lead to osteoarthritis? Re-examining the evidence for early treatment

There are many good reasons to improve the anatomy of a distal radius fracture, such as early return to function and avoidance of sigmoid notch incongruity or ulnocarpal impaction. It is often feared by patients, and portrayed by some authors of scientific articles and medicolegal reports, that a fracture of the distal radius has a propensity to cause symptomatic osteoarthritis. This article examines some of the current evidence and shares the authors’ experience. Critical questions are asked to direct our observations and guide future research questions. We propose that both clinical experience and a literature analysis do not support the commonly held assumption that untreated distal radial fractures lead to symptomatic osteoarthritis. Level of evidence: V