Biology versus mechanics in the treatment of distal radial fractures.

This manuscript aims to address the biologic and mechanical principles underlying the treatment of displaced distal radial fractures. A literature review was performed using Ovid Medline 1950-2007 and all evidence-based medicine reviews. A recent Cochrane review and a meta-analysis were reference searched. All randomized trials comparing internal and external fixation and all articles related to volar locked plates were searched for. Based on current literature, there is no evidence to support internal fixation with plates over minimally invasive fixation with external fixation. Recent results using volar locked plate fixation are promising, but comparative studies with either conventional plating or external fixation are lacking.