The purpose of this study was to quantify the functional impairment following distal radial fractures and to identify the factors affecting prognosis. One hundred fifteen patients were assessed six months and two years following initial injury. On final assessment, subjectively, 56% had good, 39% had fair, and 5% had poor results. Median grip strength improved from 51% to 78%, range of movement from 87% to 94%, and wrist torque from 93% to 100%. Redisplacement occurred in 59%; only 33% clinically and 19% radiologically had perfect cosmetic results. Radial malunion was important functionally. Only when the dorsal angle exceeded 20 degrees or the radial angle fell below 10 degrees with a 30 degrees mean was there reduction in grip strength (p = 0.05). Comminution and intraarticular involvement predisposed to a median loss of movement of 15% and 11%, respectively (p = less than 0.05). Patients requiring physiotherapy formed a poor prognostic group. A combination of factors is responsible for poor results. Attention should be directed toward early and adequate rehabilitation of the injured hand and wrist.