Distal radius fractures and navicular fractures are common injuries in the adult population. With the associated improved outcomes and advances in internal fixation techniques, an increasing number of distal radius fractures and navicular fractures have been treated surgically in recent years. Potential soft tissue, neurovascular, or bony complications associated with surgery include tendon injury, carpal tunnel syndrome, fracture re-displacement, and osteonecrosis, which can prolong braking time as well as the number of surgeries and may lead to poor outcomes. Timely recognition of these complications and proper diagnosis may help improve outcomes and patient satisfaction. Complications of distal radius fractures Distal radius fractures are a common orthopedic injury, accounting for 10-25% of all fractures, predisposing people of all ages, and can result from both high- and low-energy trauma. In the United States, 85,000 Medicare beneficiaries have a distal radius fracture each year, and the percentage of those who receive surgical treatment is increasing each year. A shortening of the distal radius of even 2.5 mm can severely increase the load transmitted by the distal ulna, which can lead to wrist pain, abnormal wrist motion mechanics, and the development of early arthritic lesions. Therefore, it is important to fully understand the complications associated with the treatment of distal radius fractures and how to properly manage them. A variety of treatment options are available for distal radius fractures, including closed reduction external braking or direct fixation without reduction, percutaneous kyphotic pin fixation, external brace fixation, and incisional reduction internal fixation (ORIF), which can be performed with dorsal plates, metacarpal plates, or specific fracture fragments. The American Academy of Orthopaedic Surgeons (AAOS) published guidelines for the treatment of distal radius fractures in 2010, which include recommendations for surgical fixation based on imaging parameters. This guideline recommends surgical fixation if the radius is shortened >3 mm after manipulation, radial deviation >10o, or if the intra-articular fracture mass is displaced or step-like >2 mm. However, the authors of this guideline cannot support or oppose the use of any particular surgical approach. In recent years, the fixation method with a palmar fixation angle plate has been commonly applied. Because this method of plate fixation does not depend on the plate’s support, it can be used for all palmarly or dorsally inclined fractures, as well as fractures with fracture lines extending to the articular surface or comminuted fractures. The plate is screwed to the subchondral bone at the articular surface and neutralizes the load through the broken end of the fracture. In addition, this locking plate device does not require good local bone quality and can thus be used for osteoporotic bones or comminuted fractures. Soft Tissue Complications Distal radius fractures, whether treated surgically or conservatively, can have the complication of tendon irritation and rupture. Although this complication has traditionally been associated with dorsal plate fixation, tendon irritation and rupture can also occur with palmar plate fixation or even external plaster fixation. The tendon most commonly ruptured is the long extensor thumb tendon, and complications are more likely to occur with extensor tendons than with flexor tendons. Tendon rupture, particularly of the long extensor thumb tendon, can occur in up to 3% of cases after nonoperative treatment of distal radius fractures. The cause is usually thought to be mechanical abrasion of the tendon by the internal fixation and/or vascular injury.