An Acta Orthopaedica educational article: Choosing treatment with an elderly patient having a distal radius fracture.

Distal radius fractures in adults primarily occur in the elderly, in whom comorbidity, polypharmacy, dependency, and limited functional demands often coexist. Most patients have been managed non-surgically with casting. However, only a few trials with high evidence exist on comparing non-surgical and surgical treatments in the elderly. Given the heterogeneity of the aging population, a universal approach to treatment selection may not be feasible. This educational article aims to discuss the advantages and disadvantages of non-surgical vs surgical management, radiological assessment, complication risks, and osteoporosis screening. Moreover, we suggest surgical technical tips, a treatment algorithm, and a decision-making strategy that considers both functional demands and individual needs.