Introduction: The objective of this systematic review was to analyze (1) prevalence of radiological posttraumatic arthritis (PA), (2) associations of PA with outcome measures and (3) predictors of PA following distal radius fractures in non-osteoporotic patients. Materials and methods: Nineteen studies were included (10 open source data). Results: In total, 733 patients were described with a weighted mean age of 37 years (range 25–54) at the time of the injury. Follow-up ranged from 13 months to 38 years. Overall prevalence of PA was 50% and 37% in the open source data. Radial deviation was significantly worse in patients with PA (N = 49, mean 14°, SD 6° versus N = 55, mean 17°, SD 6°, p = 0.037). No analysis could be performed regarding patient reported outcome measures, because of limited data. Articular incongruence was a significant predictor for PA. Conclusions: A high prevalence of PA was found in non-osteoporotic patients following a distal radius fracture. PA following a distal radial fracture was associated with a limited radial deviation and flexion, but not with grip strength. Articular incongruence predicted PA. Patient reported outcome measures should be investigated more thoroughly to be able to understand the value of using these instruments in interpreting outcome in follow-up of non-osteoporotic patients following a distal radius fracture. Level of evidence: Level of evidence 3 (Phillips et al. Levels of Evidence—Oxford Centre for Evidence-based Medicine, 1).