of the distal radius, accessing the depression of dorsal rim of the lunate facet, and the position of the screws on the ulnar side of the distal end radius. Classification There are many classification systems for distal radius fracture. AO/OTA classification is adopted by Orthopaedic Trauma Association and is the most commonly used classification system. There are three major groups: A—extra-articular, B—partial articular, and C—complete articular which can further subdivided into nine main groups and 27 subgroups depending on the degree of communication and direction of displacement. However, none of the classification systems demonstrate good liability. A qualification modifier (Q) is used for associated ulnar fracture. For children and adolescents, there are three main categories of fracture: buckle (torus) fractures, greenstick fractures, and complete (or off-ended) fractures. Buckle fractures are an incomplete break in the bone that involves the cortex (outside) of the bone. Buckle fractures are stable and are the most common type. Greenstick fractures are a bone that is broken only on one side and the bone bows to the other side. Greenstick fractures are unstable and often occur in younger children. Complete fractures, where the bone is completely broken, are unstable. In a complete fracture the bone can be misaligned. For a complete fracture, a closed fractures are those in which the skin and tissue lying over the bone is intact. An open fracture (exposed bone) is a serious injury. Treatment Correction should be undertaken if the wrist radiology falls outside the acceptable limits: 2-3mm positive ulnar variance There should be no carpus malalignment If carpus is aligned, then the dorsal tilt should be less than 10 degrees If carpus is aligned, there are no limits for palmar tilt If carpus is malaligned, wrist tilt should be neutral Gap or step deformity is less than 2mm Treatment options for distal radius fractures include nonoperative management, external fixation, and internal fixation. Indications for each depend on a variety of factors such as the patient's age, initial fracture displacement, and metaphyseal and articular alignment, with the ultimate goal to maximize strength and function in the affected upper extremity. Surgeons use these factors combined with radiologic imaging to predict fracture instability, and functional outcome to help decide which approach would be most appropriate. Treatment is often directed to restore normal anatomy to avoid the possibility of malunion, which may cause decreased strength in the hand and wrist. The decision to