To find the best treatment method by comparing the curative effect of surgical and non-surgical treatment of distal radius fractures in the elderly.

From March 2012 to September 2016, 128 cases of distal radius fractures in the elderly from Beijing Geriatric Hospital were treated by manual reduction and plaster external fixation (non-operative group, 72 cases) and open reduction and internal fixation (operative group, 56 cases). According to the AO classification, there were 33 cases of type A, 23 cases of type B, and 16 cases of type C in the non-operative group, and there were 10 cases of type A, 12 cases of type B, and 34 cases of type C in the operative group. The Chi-square test was used to compare the excellent/good rate between the non-operative group and operative group.

One hundred and nineteen patients were followed for 6 to 24 months, with an average period of (15.2±1.9) months. The wrist function was assessed according to the Cooney's functional scoring criteria, and the excellent/good rate was 83.3% in the non-operative group and 94.6% in the operation group.

For elderly patients with distal radius fracture, the excellent/good rate of open reduction and internal fixation is higher than that of manual reduction and gypsum external fixation. For stable or relatively stable distal radius fracture, manual reduction is still the preferred treatment.