Distal radius fractures are commonly encountered in orthopedic practice especially in elderly patients. A number of clinical papers have supported the idea that anatomic restoration of the distal end of the radius is essential to gain superior results. The aim of the study is to systematically review the literature for management of distal end radius in elderly persons (conservative treatment versus percutaneous wire fixation) as regards radiological and functional outcomes.Studies were identified from the Medline, Cochrane, EMBASE, and Google Scholar databases were searched until, 2019 using combinations of the following search terms: distal radius fracture, conservative treatment, non-operative treatment, and nonsurgical treatment, surgical treatment, operative, elderly, and older. Reference lists of relevant studies were manually searched.There was no statistical significance difference between CI and PKF groups' frequency of complication in all of the selected studies. Based on results we recommend for more analysis regarding every parameter of the radiographic and functional results and specific complication related to each fixation need to be accomplished, which requires more RCTs with high quality.Surgical treatment seems to be more effective distal radius fracture compared with conservative treatment when the radiographic outcomes were analyzed, and no significant differences were detected in the functional outcomes and complication rate.