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Distal Radius Fracture

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Distal radius fractures — assessment, casting, and indications for surgical fixation.

Updated Aug 20264 citations
A hand-drawn illustration of a faceless person who has fallen forward onto an outstretched hand, the wrist taking the impact.
X-ray of a displaced distal radius fracture — the most common adult fracture pattern. The end of the forearm bone has snapped just above the wrist joint and shifted out of line. Kieran Hirpara 4.0

What you're feeling

The injury usually happens in a split second. You might fall onto an outstretched hand or take a direct blow to the wrist. You likely hear or feel a snap or pop. Pain hits immediately and sharply. Your wrist swells up fast. Bruising often appears within hours. The area feels tender to the touch.

You may notice your wrist looks bent or misshapen. This deformity can be quite obvious. Moving the wrist feels difficult and painful. You might find it hard to grip objects or lift even a light cup. Your hand may feel numb or tingly if nerves are affected. In rare cases, you could experience weakness in both the thumb and little finger nerves at the same time. This combined nerve issue is uncommon but requires specific attention.

In the first few days, pain is often worse at night. Swelling can make the skin feel tight. Simple tasks like turning a doorknob or typing become challenging. You will likely want to keep the arm still to avoid sharp pains. Your surgeon will focus on preventing complications, as soft tissue issues can sometimes be more problematic than the bone break itself.

As healing begins over the next few weeks, the sharp pain starts to settle. It may still ache when you move or bear weight on the hand. Nighttime discomfort usually decreases as swelling goes down. You might feel a sense of relief as the initial shock fades. However, you must remain cautious. Early diagnosis and treatment are vital to avoid long-term consequences. Ignoring signs of injury, such as persistent numbness or inability to move fingers, can lead to arthritis within 10 years if intrinsic carpal ligament injuries are missed.

Your recovery path depends on accurate early assessment. We aim to restore the bone to its natural alignment to support your return to function. While the risk of the bone failing to heal is minimal, soft tissue healing takes time. You may experience some stiffness as you begin gentle movements. This is a normal part of the process. Your surgeon will guide you on when it is safe to start using your hand for daily activities.

What's actually happening

Your wrist is a complex hinge where your forearm bones meet your hand. When you fall, that force travels up your arm and can crack the end of your radius bone. This is the larger of your two forearm bones. The break often happens near the joint surface. Sometimes, the smaller ulna bone also breaks at its tip.

Think of your wrist like a tent pole. If the pole cracks or bends, the whole structure becomes unstable. Your bones no longer hold your hand in the right place. This makes it painful and difficult to move your wrist or grip objects. The bones may shift out of alignment, a process called displacement. If they are not held steady while they heal, they can grow back in a crooked position.

Your surgeon’s main goal is to put the bones back in their correct position. This is called restoration of anatomic alignment. We then hold them there while your body heals them. This might involve using plates and screws inside the bone, or pins and an external frame outside the skin. The choice depends on how severe the break is.

Healing happens when new bone tissue knits the pieces together. In many cases, the risk of the bone failing to heal (nonunion) is very low. However, if the break is severe, we might use bone graft substitutes. These materials act like scaffolding to give the area extra strength and stability while your own bone grows. This support helps you start moving your hand sooner.

Sometimes, the broken bone fragments press on nearby nerves. The median and ulnar nerves run through your wrist. Combined damage to both nerves is exceedingly rare. But if it happens, it needs careful management to avoid long-term issues like numbness or weakness. Early treatment helps prevent these complications.

We also watch for changes in the bone’s height. Even with modern fixation methods, some loss of height can occur as the bone settles. This is normal to a degree. We monitor this closely to ensure your wrist remains stable and functional. An associated break in the ulna tip does not usually change the outcome for the radius fracture itself.

What we can do about it

Dr Kieran Hirpara, an upper-limb surgeon at Mater Private Hospital Rockhampton, starts with the least invasive options that suit your condition. We match the treatment to your specific injury pattern, severity, and stability. If your fracture is stable or only slightly displaced, we often begin with non-operative care. This usually involves a sling, splint, or cast to hold the bone in place while it heals. We monitor your progress with repeat X-rays to ensure the bones stay aligned. You will then start a staged return to movement with physiotherapy to restore strength and flexibility.

Surgery is recommended from the outset if your fracture is displaced, unstable, or if you have high functional demands. We may also suggest surgery if non-operative care leaves you with unacceptable pain or if the final position of the bone does not meet your needs. For example, volar plating (using a metal plate on the palm side of the wrist) can provide superior radiological results compared to k-wiring (using thin metal pins). However, these better X-ray images do not always correlate with a better functional outcome at 32 months follow up. We discuss these options with you so you can make a shared decision that fits your life and goals.

Both paths share the same core goals in the early weeks: controlling your pain, protecting the injury while it heals, and preparing for rehabilitation. We emphasize that complications associated with soft tissues may be more problematic than the bone injury itself. Early diagnosis and treatment of any complications are important to avoid long-term consequences. We also note that combined median and ulnar nerve palsy related to distal radius fractures is exceedingly rare, but if it occurs, it requires a standardised management strategy. Patients are generally referred to our clinic by their GP; if a physiotherapist has suggested you see us, you will still need a referral from your GP in order to be eligible for the Medicare rebate.

What to expect

Your bone typically heals within a few months. The risk of the bone failing to join together is minimal. You will likely wear a cast or splint for several weeks. This keeps the bone steady while it knits back together. Your surgeon will monitor your progress with X-rays to ensure the alignment is correct.

Recovery feels different depending on the treatment path. If you have surgery, your surgeon may use a plate or pins to hold the bone in place. These methods help restore the bone’s shape. However, better X-ray results do not always mean better hand function later. Some patients notice a small loss in bone height over time. If you choose non-operative care, your arm will heal in a cast. This avoids surgery but requires careful monitoring to prevent stiffness.

You can expect to return to daily tasks gradually. Bone graft substitutes may help you move your hand earlier. This supports structural stability and encourages early function. Most people resume light activities within weeks. Heavier work or sports may take several months. Your surgeon will guide you on when it is safe to increase activity.

Complications are uncommon but possible. Nerve issues affecting both the median and ulnar nerves are exceedingly rare. If they occur, your surgeon will manage them with a standard strategy. An associated fracture on the pinky side of the wrist does not typically affect your final outcome. Stiffness is a common challenge. Your surgeon will focus on preventing long-term consequences through early diagnosis and treatment of any issues.

Your primary concern during recovery is protecting the healing bone. Avoid heavy lifting until cleared. Keep your hand elevated to reduce swelling. Attend all follow-up appointments so your surgeon can check your progress. Most patients regain good use of their hand. Some may experience lingering stiffness or mild discomfort. Your surgeon will work with you to maximise your recovery.

When to see someone

Seek urgent care if you have a visible deformity, an open wound, numbness or tingling, or cannot use your arm. Early diagnosis is important to avoid long-term consequences of distal radius fracture complications. Soft tissue complications may be more problematic than the bone injury itself. Delayed diagnosis of intrinsic carpal ligament injuries leads to arthritis within 10 years if not treated. See your GP or ask for a specialist review if pain is not settling. Also seek advice if swelling, movement, or function are not improving week on week as healing progresses. Early recognition of associated injuries is associated with improved outcomes.

Advanced reading: the deeper science (optional)

This section goes further than you need for your own treatment decisions. A broken wrist is worth the extra reading because it is the fracture where the gap between what looks right on an X-ray and what a patient actually notices is widest — and because the commonest operation for it has a higher complication rate than most people are told.

Surgery improves function, but by how much matters

Pooling 2,254 adults, operative treatment of distal radius fractures improved the medium-term DASH score and grip strength compared with non-operative treatment, with no difference in overall complication rate [1].

That is a genuine result in favour of surgery, and it should be read alongside its own size. The DASH is scored out of 100, and the differences in this literature are typically modest — real, measurable, and often smaller than patients imagine when they hear "surgery gives a better result". It is a difference in the quality of the recovery rather than the difference between a working wrist and a useless one.

The plate has its own complication profile

The volar locking plate is the standard fixation, and it is very good. It is not free.

A meta-analysis restricted to high-quality studies found an overall complication rate of 30.8% after volar locking plate fixation, and noted the technique may be associated with more hardware-related complications than previously reported [2].

That figure needs context rather than alarm: it counts everything, including minor and self-resolving problems, not 30.8% disasters. But it is the honest denominator, and it is higher than the impression given by "a plate and screws, then straight to moving your hand".

Removal is a related question with a clean answer. Across 3,690 patients there was a strong positive correlation between how often surgeons removed hardware and how often complications were reported, and the authors concluded that routine removal is not justified in the absence of plate-related problems [3]. A plate that is not causing trouble should generally be left alone.

The ulnar styloid fracture you were told about probably does not matter

Most people with a distal radius fracture also break the tip of the ulna, and it is often mentioned as though it were a second, worrying injury.

Pooling 1,403 patients, a concomitant ulnar styloid fracture did not affect the outcomes of the distal radius fracture, and the authors advise caution before electing to fix it [4].

So if that fragment was pointed out on your X-ray, its presence alone is not a reason for additional surgery, and not a reason to expect a worse result.

What actually predicts a poor outcome

Not the ulnar styloid, and not the surgeon's choice of implant so much as the fracture's own behaviour. Where a fracture is managed in a cast, the risk factors for it slipping again after reduction include initial complete displacement and other markers of an unstable pattern — the fracture that was badly out of position to begin with is the one most likely to drift back.

That is why a wrist treated in plaster is X-rayed again at one and two weeks. The check is not bureaucratic; it is the window in which a slipping fracture can still be dealt with easily.

Reviewed by AI synthesis (v2) — pending human review · 18 May 2026.

Want the clinical detail? Read the clinician version.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

References for the advanced reading
  1. Ochen Y, Peek J, van der Velde D, Beeres FJP, van Heijl M, Groenwold RHH, et al. Operative vs nonoperative treatment of distal radius fractures in adults: a systematic review and meta-analysis. JAMA Netw Open. 2020;3(4):e203497.
  2. Nwosu C, Rodriguez K, Zeng S, Klifto KM, Klifto CS, Ruch DS. Complications following volar locking plate fixation of distal radius fractures: a systematic review and meta-analysis. J Hand Surg Am. 2023;48(9):861-74.
  3. Yamamoto M, Fujihara Y, Fujihara N, Hirata H. A systematic review of volar locking plate removal after distal radius fracture. Injury. 2017;48(12):2650-6.
  4. Yuan C, Zhang H, Liu H, Gu J. Does concomitant ulnar styloid fracture and distal radius fracture portend poorer outcomes? A meta-analysis. Injury. 2017;48(11):2575-81.
Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

  • Prevention of complications associated with distal radius fractures should be the treating surgeon's primary concern [1].
  • Early diagnosis and treatment are important to avoid long-term consequences of distal radius fracture complications [1].
  • Combined median and ulnar nerve palsy related to distal fractures of the radius is exceedingly rare [2].
  • Combined median and ulnar nerve palsy complicating distal radius fractures require a standardised management strategy [2].
  • Optimal outcomes in the treatment of forearm fracture–dislocations depend on early recognition and management [4].
  • Restoration and maintenance of anatomic alignment are key principles for optimal outcomes in forearm fracture–dislocations [4].
  • Novel locking plate designs have resulted in a rethinking of the contemporary approach to distal radius fracture fixation [6].
  • A certain degree of radial height loss is noted in patients undergoing fracture fixation with volar locking plate for extra-articular distal radius fractures [7].
  • An associated ulnar styloid fracture does not affect the outcomes of a distal radial fracture [8].
  • Clinicians should be cautious in electing operative treatment for patients with an ulnar styloid fracture [8].
  • Bone graft substitutes are primarily used to provide structural stability in distal radius fractures [9].
  • Bone graft substitutes may facilitate early return to function in distal radius fractures [9].
  • The risk of nonunion is minimal in distal radius fractures [9].
  • External fixation supplemented with percutaneous pins is an excellent option for treating displaced fractures of the distal radius [10].
  • External fixation supplemented with percutaneous pins yields reliably good results for displaced distal radius fractures [10].
  • External fixation supplemented with percutaneous pins has a low reoperation rate for displaced distal radius fractures [10].
  • External fixation supplemented with percutaneous pins has a low complication rate for displaced distal radius fractures [10].
  • Die punch fragment size is not an indicator of the need for or use of a dorsal approach in distal radius fracture fixation [17].

Anatomy & Pathophysiology

  • Prevention of complications associated with distal radius fractures should be the treating surgeon's primary concern, with early diagnosis and treatment being important to avoid long-term consequences [1].
  • Combined median and ulnar nerve palsy related to distal fractures of the radius are exceedingly rare but require a standardized management strategy [2].
  • Optimal outcomes in the treatment of forearm fracture–dislocations depend on early recognition and management, with restoration and maintenance of anatomic alignment being the key principles [4].
  • An associated ulnar styloid fracture does not affect the outcomes of a distal radial fracture and clinicians should be cautious in electing operative treatment for patients with an ulnar styloid fracture [8].
  • Bone graft substitutes are primarily used to provide structural stability and perhaps early return to function in distal radius fractures, where the risk of nonunion is minimal [9].
  • Metaphyseal collapse ratio, a novel radiographic parameter, was found to provide a reliable measure of metaphyseal comminution, and to be significantly correlated with other radiographic parameters that predict distal radius fracture instability [11].
  • There may be radiographic factors other than measures of deformity that some surgeons use to determine recommendations for surgery [12].
  • Early accurate diagnosis of intrinsic carpal ligament injuries provides for best outcomes, while delayed diagnosis leads to arthritis within 10 years if not treated [16].
  • DP fragment size is not an indicator of the need for or use of a dorsal approach in distal radius fracture fixation [17].
  • Pronation effectively increases the proximal 'safe zone' of the posterior interosseous nerve, suggesting the forearm should be placed in pronation to minimize the risk of iatrogenic injury [18].
  • CT scan should be requested only by experienced hand surgeons in order to help guide treatment, as it does not significantly improve inter- and intra-observer agreement for all classification systems [20].

Classification

  • CT scans do not significantly improve inter- and intra-observer agreement for the AO, Fernandez, and Universal classification systems for distal radius fractures [20].
  • The metaphyseal collapse ratio (MCR) is a novel radiographic parameter that provides a reliable measure of metaphyseal comminution [11].
  • The metaphyseal collapse ratio (MCR) is significantly correlated with other radiographic parameters that predict distal radius fracture instability [11].

Clinical Presentation

  • Bone graft substitutes are primarily used to provide structural stability and perhaps early return to function in distal radius fractures [9].
  • Metaphyseal collapse ratio is a novel radiographic parameter that provides a reliable measure of metaphyseal comminution [11].
  • Metaphyseal collapse ratio is significantly correlated with other radiographic parameters that predict distal radius fracture instability [11].
  • There may be radiographic factors other than measures of deformity that some surgeons use to determine recommendations for surgery in distal radius fractures [12].
  • Soft tissue complications encountered during the management of distal radius fractures include tendon injury, nerve dysfunction, vascular compromise, skin problems, compartment syndrome, and complex regional pain syndrome [15].
  • Complications associated with soft tissues may be more problematic than the bone injury itself in distal radius fractures [15].
  • Early accurate diagnosis of intrinsic carpal ligament injuries provides for best outcomes [16].
  • Delayed diagnosis of intrinsic carpal ligament injuries leads to arthritis within 10 years if not treated [16].
  • Pronation effectively increases the proximal 'safe zone' of the posterior interosseous nerve [18].
  • The forearm should be placed in pronation to minimize the risk of iatrogenic injury to the posterior interosseous nerve [18].
  • Monteggia fractures can be easily overlooked if radiographs of the elbow are not taken [19].
  • Pre-existing congenital radial head dislocations can lead to inappropriate surgical intervention if not distinguished from Monteggia fractures [19].
  • Early recognition and treatment of Essex-Lopresti injury is associated with improved outcomes [21].

Investigations

  • Early diagnosis and treatment of complications associated with distal radius fractures are important to avoid long-term consequences [1].
  • Combined median and ulnar nerve palsy related to distal radius fractures is exceedingly rare [2].
  • Restoration and maintenance of anatomic alignment are key principles in the treatment of forearm fracture–dislocations [4].
  • Pre-existing congenital radial head dislocations can lead to inappropriate surgical intervention if misdiagnosed as Monteggia fractures [19].

Treatment

  • Bone graft substitutes are used to perhaps provide early return to function in distal radius fractures [9].
  • External fixation supplemented with percutaneous pins for displaced distal radius fractures yields reliably good results [10].
  • External fixation supplemented with percutaneous pins for displaced distal radius fractures has a low reoperation rate [10].
  • External fixation supplemented with percutaneous pins for displaced distal radius fractures has a low complication rate [10].
  • Superior radiological results were attained with volar plating compared to k-wiring for distal radius fractures [13].
  • Superior radiological results with volar plating did not correlate with a better functional outcome compared to k-wiring at 32 months follow up [13].

Complications

  • Early diagnosis and treatment of complications are important to avoid long-term consequences [1].
  • Bone graft substitutes may provide early return to function in distal radius fractures [9].
  • The risk of nonunion in distal radius fractures is minimal [9].

Recovery

  • Combined median and ulnar nerve palsy complicating distal radius fractures requires a standardised management strategy [2].
  • Volar plating attains superior radiological results compared to k-wiring for distal radius fractures [13].
  • Superior radiological results with volar plating do not correlate with better functional outcomes compared to k-wiring at 32 months follow up [13].

Key Evidence

  • [Paper] Prevention of complications associated with distal radius fractures should be the treating surgeon's primary concern, with early diagnosis and treatment being important to avoid long-term consequences. [1] (10.1016/j.hcl.2014.12.002)
  • [Paper] Combined median and ulnar nerve palsy related to distal fractures of the radius are exceedingly rare but require a standardised management strategy. [2] (10.1016/j.otsr.2018.04.026)
  • [L5] Optimal outcomes in the treatment of forearm fracture–dislocations depend on early recognition and management, with restoration and maintenance of anatomic alignment being the key principles. [4] (10.1016/j.hcl.2015.01.010)
  • [Paper] The management of distal radius fractures is in the midst of a renaissance with novel locking plate designs resulting in a rethinking of the contemporary approach to fracture fixation. [6] (10.1016/j.hcl.2005.04.001)
  • [Paper] A certain degree of radial height loss is noted in patients undergoing fracture fixation with volar locking plate for extra-articular distal radius fractures. [7] (10.1016/j.otsr.2021.102842)
  • [L1] Based on this meta-analysis, an associated ulnar styloid fracture does not affect the outcomes of a distal radial fracture and clinicians should be cautious in electing operative treatment for patients with an ulnar styloid fracture. [8] (10.1016/j.injury.2017.08.061)
  • [L4] Bone graft substitutes are primarily used to provide structural stability and perhaps early return to function in distal radius fractures, where the risk of nonunion is minimal. [9] (10.1016/j.hcl.2012.02.004)
  • [L1] External fixation supplemented with percutaneous pins is an excellent option for treating displaced fractures of the distal radius, with reliably good results, a low reoperation rate, and a low complication rate. [10] (10.1016/j.hcl.2009.08.008)
  • [Paper] Metaphyseal collapse ratio, a novel radiographic parameter, was found to provide a reliable measure of metaphyseal comminution, and to be significantly correlated with other radiographic parameters that predict distal radius fracture instability. [11] (10.1016/j.otsr.2013.05.002)
  • [Paper] There may be radiographic factors other than measures of deformity that some surgeons use to determine recommendations for surgery. [12] (10.1007/s12593-014-0164-0)
  • [L3] Although superior radiological results were attained with volar plating, these results did not correlate with a better functional outcome compared to k-wiring at 32 months follow up. [13] (10.1016/j.injury.2015.08.040)
  • [L5] This review focuses on soft tissue complications encountered during the management of distal radius fractures, including tendon injury, nerve dysfunction, vascular compromise, skin problems, compartment syndrome, and complex regional pain syndrome, noting that complications associated with soft tissues may be more problematic than the bone injury itself. [15] (10.1016/j.hcl.2009.11.002)
  • [L5] Early accurate diagnosis of intrinsic carpal ligament injuries provides for best outcomes, while delayed diagnosis leads to arthritis within 10 years if not treated. [16] (10.1016/j.hcl.2015.01.003)
  • [Paper] DP fragment size is not an indicator of the need for or use of a dorsal approach in DRF fixation. [17] (10.1055/s-0040-1712328)
  • [Paper] Pronation effectively increases the proximal 'safe zone' of the nerve, suggesting the forearm should be placed in pronation to minimize the risk of iatrogenic injury. [18] (10.1016/j.injury.2015.01.028)
  • [L4] Monteggia fractures can be easily overlooked if radiographs of the elbow are not taken, and pre-existing congenital radial head dislocations can lead to inappropriate surgical intervention. [19] (10.1016/j.injury.2005.08.028)
  • [Paper] CT scan should be requested only by experienced hand surgeons in order to help guide treatment, as it does not significantly improve inter- and intra-observer agreement for all classification systems. [20] (10.1016/j.injury.2014.06.017)
  • [L5] Early recognition and treatment is associated with improved outcomes. [21] (10.1016/j.hcl.2020.07.012)

References

[1] Management of Complications of Distal Radius Fractures. Hand Clinics. 2015. DOI: 10.1016/j.hcl.2014.12.002

[2] Combined median and ulnar nerve palsy complicating distal radius fractures. Orthopaedics & Traumatology: Surgery & Research. 2018. DOI: 10.1016/j.otsr.2018.04.026

[4] Management of Complications of Forearm Fractures. Hand Clinics. 2015. DOI: 10.1016/j.hcl.2015.01.010

[6] Distal Radius Fractures. Hand Clinics. 2005. DOI: 10.1016/j.hcl.2005.04.001

[7] Loss of radial height in extra-articular distal radial fracture following volar locking plate fixation. Orthopaedics & Traumatology: Surgery & Research. 2021. DOI: 10.1016/j.otsr.2021.102842

[8] Does concomitant ulnar styloid fracture and distal radius fracture portend poorer outcomes? A meta-analysis of comparative studies. Injury. 2017. DOI: 10.1016/j.injury.2017.08.061

[9] The Use of Bone Grafts and Substitutes in the Treatment of Distal Radius Fractures. Hand Clinics. 2012. DOI: 10.1016/j.hcl.2012.02.004

[10] External Fixation of Distal Radius Fractures. Hand Clinics. 2010. DOI: 10.1016/j.hcl.2009.08.008

[11] Distal radius fracture metaphyseal comminution: A new radiographic parameter for quantifying, the metaphyseal collapse ratio (MCR). Orthopaedics & Traumatology: Surgery & Research. 2013. DOI: 10.1016/j.otsr.2013.05.002

[12] Radiographs Versus Radiographic Measurements in Distal Radius Fractures. Journal of Hand and Microsurgery. 2015. DOI: 10.1007/s12593-014-0164-0

[13] Volar plate versus k-wire fixation of distal radius fractures. Injury. 2016. DOI: 10.1016/j.injury.2015.08.040

[15] Soft Tissue Complications of Distal Radius Fractures. Hand Clinics. 2010. DOI: 10.1016/j.hcl.2009.11.002

[16] Management of Complications of Ligament Injuries of the Wrist. Hand Clinics. 2015. DOI: 10.1016/j.hcl.2015.01.003

[17] The Die Punch Fragment: Analysis of Fragment Geometry and Need for Fixation. Journal of Hand and Microsurgery. 2022. DOI: 10.1055/s-0040-1712328

[18] The course of the posterior interosseous nerve in relation to the proximal radius: Is there a reliable landmark?. Injury. 2015. DOI: 10.1016/j.injury.2015.01.028

[19] When is a Monteggia fracture not a Monteggia fracture?. Injury Extra. 2007. DOI: 10.1016/j.injury.2005.08.028

[20] Does the CT improve inter- and intra-observer agreement for the AO, Fernandez and Universal classification systems for distal radius fractures?. Injury. 2014. DOI: 10.1016/j.injury.2014.06.017

[21] The Essex-Lopresti Injury:. Hand Clinics. 2020. DOI: 10.1016/j.hcl.2020.07.012

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4. Media and formats; technical modifications allowed. The Licensor authorizes You to exercise the Licensed Rights in all media and formats whether now known or hereafter created, and to make technical modifications necessary to do so. The Licensor waives and/or agrees not to assert any right or authority to forbid You from making technical modifications necessary to exercise the Licensed Rights, including technical modifications necessary to circumvent Effective Technological Measures. For purposes of this Public License, simply making modifications authorized by this Section 2(a) (4) never produces Adapted Material.

5. Downstream recipients.

a. Offer from the Licensor -- Licensed Material. Every recipient of the Licensed Material automatically receives an offer from the Licensor to exercise the Licensed Rights under the terms and conditions of this Public License.

b. No downstream restrictions. You may not offer or impose any additional or different terms or conditions on, or apply any Effective Technological Measures to, the Licensed Material if doing so restricts exercise of the Licensed Rights by any recipient of the Licensed Material.

6. No endorsement. Nothing in this Public License constitutes or may be construed as permission to assert or imply that You are, or that Your use of the Licensed Material is, connected with, or sponsored, endorsed, or granted official status by, the Licensor or others designated to receive attribution as provided in Section 3(a)(1)(A)(i).

b. Other rights.

1. Moral rights, such as the right of integrity, are not licensed under this Public License, nor are publicity, privacy, and/or other similar personality rights; however, to the extent possible, the Licensor waives and/or agrees not to assert any such rights held by the Licensor to the limited extent necessary to allow You to exercise the Licensed Rights, but not otherwise.

2. Patent and trademark rights are not licensed under this Public License.

3. To the extent possible, the Licensor waives any right to collect royalties from You for the exercise of the Licensed Rights, whether directly or through a collecting society under any voluntary or waivable statutory or compulsory licensing scheme. In all other cases the Licensor expressly reserves any right to collect such royalties, including when the Licensed Material is used other than for NonCommercial purposes.

Section 3 -- License Conditions.

Your exercise of the Licensed Rights is expressly made subject to the following conditions.

a. Attribution.

1. If You Share the Licensed Material (including in modified form), You must:

a. retain the following if it is supplied by the Licensor with the Licensed Material:

i. identification of the creator(s) of the Licensed Material and any others designated to receive attribution, in any reasonable manner requested by the Licensor (including by pseudonym if designated);

ii. a copyright notice;

iii. a notice that refers to this Public License;

iv. a notice that refers to the disclaimer of warranties;

v. a URI or hyperlink to the Licensed Material to the extent reasonably practicable;

b. indicate if You modified the Licensed Material and retain an indication of any previous modifications; and

c. indicate the Licensed Material is licensed under this Public License, and include the text of, or the URI or hyperlink to, this Public License.

2. You may satisfy the conditions in Section 3(a)(1) in any reasonable manner based on the medium, means, and context in which You Share the Licensed Material. For example, it may be reasonable to satisfy the conditions by providing a URI or hyperlink to a resource that includes the required information.

3. If requested by the Licensor, You must remove any of the information required by Section 3(a)(1)(A) to the extent reasonably practicable.

4. If You Share Adapted Material You produce, the Adapter's License You apply must not prevent recipients of the Adapted Material from complying with this Public License.

Section 4 -- Sui Generis Database Rights.

Where the Licensed Rights include Sui Generis Database Rights that apply to Your use of the Licensed Material:

a. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database for NonCommercial purposes only;

b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.

Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

Creative Commons may be contacted at creativecommons.org.